Healthcare Provider Details

I. General information

NPI: 1124371265
Provider Name (Legal Business Name): IMPERIAL HEALTH LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2012
Last Update Date: 01/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 BEGLIS PKWY SUITE 2
SULPHUR LA
70663-3502
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 337-436-3813
  • Fax:
Mailing address:
  • Phone: 337-433-8400
  • Fax: 337-312-6708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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