Healthcare Provider Details

I. General information

NPI: 1679672075
Provider Name (Legal Business Name): A AND L OF NORTHEAST INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 09/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 N 7TH ST SUITE C
WEST MONROE LA
71291-4212
US

IV. Provider business mailing address

700 N 7TH ST SUITE C
WEST MONROE LA
71291-4212
US

V. Phone/Fax

Practice location:
  • Phone: 318-325-5221
  • Fax:
Mailing address:
  • Phone: 318-325-5221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number4629040001
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number1567370
License Number StateLA

VIII. Authorized Official

Name: MRS. AUGUSTA TURNER
Title or Position: CEO
Credential:
Phone: 318-325-8488