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NPI Code Detail

MEDICARE: VINITA MARTIN RSW

MEDICARE:   VINITA  MARTIN  RSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2104100000XSocial Worker7760LA

General Provider Information

NPI Number : 1669829222
Entity Type Code : Individual
Provider Name (Legal Business Name) : VINITA MARTIN RSW
Provider Business Mailing Address
First Line : 6641 GOVERNMENT ST
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-6245
Country : US
Telephone Number : 225-926-9706
Fax Number : 225-926-9708
Provider Business Practice Location Address
First Line : 6641 GOVERNMENT STREET
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806
Country : US
Telephone Number : 225-926-9706
Fax Number : 225-926-9708
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2016
Last Update Date : 09/19/2018

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Directions to “ VINITA MARTIN RSW” Practice Location

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