Healthcare Provider Details

I. General information

NPI: 1194887489
Provider Name (Legal Business Name): PACEMAKER CLINIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4925 THRUSH ST
METAIRIE LA
70001-4443
US

IV. Provider business mailing address

4925 THRUSH ST
METAIRIE LA
70001-4443
US

V. Phone/Fax

Practice location:
  • Phone: 504-887-5927
  • Fax: 504-887-5981
Mailing address:
  • Phone: 504-887-5927
  • Fax: 504-887-5981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL R. DUPLECHIN
Title or Position: PRESIDENT
Credential:
Phone: 504-887-5927