Healthcare Provider Details

I. General information

NPI: 1801270194
Provider Name (Legal Business Name): IMPERIAL HEALTH, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2015
Last Update Date: 07/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 W 4TH ST
DEQUINCY LA
70633-3508
US

IV. Provider business mailing address

501 DR MICHAEL DEBAKEY DR
LAKE CHARLES LA
70601-5724
US

V. Phone/Fax

Practice location:
  • Phone: 337-222-2201
  • Fax:
Mailing address:
  • Phone: 337-312-8360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ARTHUR WEBSTER PRIMEAUX
Title or Position: EXECUTIVE COMMITTEE CHAIRMAN
Credential: M.D.
Phone: 337-433-1212