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General NPI Number Information
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NPI Number | 1356654214
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Entity Type | Organization
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Legal Business Name | TRUPATH LABORATORY LLC
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Dates
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Enumeration Date | 07/21/2010
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Last Update Date | 02/21/2011
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Provider Practice Location Address
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Address Line | 931 VERONE TER SUITE B
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City | LEESVILLE
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State | LA
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Zip | 71446-4255
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Country | US
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Telephone | 337-238-9133
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Fax | 337-238-5311
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Provider Business Mailing Address
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Address Line | 931 VERONE TER SUITE 6B
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City | LEESVILLE
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State | LA
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Zip | 71446-4255
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Country | US
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Telephone | 337-238-9133
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Fax | 337-238-5311
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. MERCEDES FICARRA
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Credential | MD
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Telephone | 337-238-9133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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