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General NPI Number Information
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NPI Number | 1295533230
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Entity Type | Organization
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Legal Business Name | MARI MEDICAL
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Dates
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Enumeration Date | 03/05/2025
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 13013 JUSTICE AVE
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City | BATON ROUGE
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State | LA
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Zip | 70816-5330
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Country | US
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Telephone | 866-696-6274
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Fax |
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Provider Business Mailing Address
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Address Line | 17732 HIGHLAND RD STE G184
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City | BATON ROUGE
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State | LA
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Zip | 70810-3846
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Country | US
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Telephone | 225-235-7404
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAMARIS MITCHELL
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Credential |
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Telephone | 225-235-7404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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