Healthcare Provider Details

I. General information

NPI: 1124762299
Provider Name (Legal Business Name): CORDOVA ARTISTRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4141 BIENVILLE ST STE 1
NEW ORLEANS LA
70119-5149
US

IV. Provider business mailing address

2673 SEA SHORE DR
MARRERO LA
70072-6077
US

V. Phone/Fax

Practice location:
  • Phone: 504-344-5612
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: LILIAN LOFTON
Title or Position: CEO
Credential: LICENSED COSMETOLOGI
Phone: 504-344-5612