=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598126898
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EQC ENTERPRISE INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/14/2016
-----------------------------------------------------
Last Update Date | 03/21/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1501 EDWARDS AVE SUITE 1
-----------------------------------------------------
City | ELMWOOD
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70123
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-766-0880
-----------------------------------------------------
Fax | 985-288-5942
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1501 EDWARDS AVE SUITE 1
-----------------------------------------------------
City | HARAHAN
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70123
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-766-0880
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MRS. ETHEL L HARRIS
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 504-265-2821
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 246RM2200X
-----------------------------------------------------
Taxonomy Name | Medical Laboratory Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 291U00000X
-----------------------------------------------------
Taxonomy Name | Clinical Medical Laboratory
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------