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General NPI Number Information
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NPI Number | 1326319666
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Entity Type | Organization
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Legal Business Name | LULING URGENT CARE, LLC
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Dates
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Enumeration Date | 01/18/2012
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Last Update Date | 10/02/2014
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Provider Practice Location Address
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Address Line | 3510 N CAUSEWAY BLVD SUITE 110
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City | METAIRIE
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State | LA
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Zip | 70002-3531
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Country | US
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Telephone | 504-846-3150
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Fax |
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Provider Business Mailing Address
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Address Line | 12895 HIGHWAY 90 SUITE H
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City | LULING
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State | LA
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Zip | 70070-2249
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. KEITH LEBLANC
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Credential |
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Telephone | 504-846-3150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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