Healthcare Provider Details

I. General information

NPI: 1811455710
Provider Name (Legal Business Name): LAZARUS HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2019
Last Update Date: 03/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2408 E 81ST ST STE 2800
TULSA OK
74137-4216
US

IV. Provider business mailing address

606 PALFREY ST
FRANKLIN LA
70538-4828
US

V. Phone/Fax

Practice location:
  • Phone: 337-254-4535
  • Fax:
Mailing address:
  • Phone: 337-254-4535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: CHARLES MATTHEWS
Title or Position: CEO
Credential:
Phone: 337-254-4535