Healthcare Provider Details

I. General information

NPI: 1639243520
Provider Name (Legal Business Name): AMERICAN LUNG ASSOCIATION OF LOUISIANA,
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2325 SEVERN AVE SUITE 8
METAIRIE LA
70001-6918
US

IV. Provider business mailing address

2325 SEVERN AVE SUITE 8
METAIRIE LA
70001-6918
US

V. Phone/Fax

Practice location:
  • Phone: 504-828-5864
  • Fax: 504-828-5867
Mailing address:
  • Phone: 504-828-5864
  • Fax: 504-828-5867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. THOMAS P LOTZ
Title or Position: EXECUTIVE DIRECTOR
Credential: MED, RRT
Phone: 504-828-5864