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General NPI Number Information
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NPI Number | 1710166368
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Entity Type | Organization
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Legal Business Name | LOUISIANA HEART HOSPITAL PROFFESION FEE, LLC
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Dates
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Enumeration Date | 10/31/2007
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Last Update Date | 04/24/2008
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Provider Practice Location Address
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Address Line | 64030 LA HWY 434
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City | LACOMBE
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State | LA
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Zip | 70445
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Country | US
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Telephone | 985-649-1152
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Fax | 985-649-1217
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Provider Business Mailing Address
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Address Line | PO BOX 840596
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City | DALLAS
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State | TX
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Zip | 75284-0596
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Country | US
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Telephone | 985-649-1152
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Fax | 985-649-1217
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Authorized Official
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Title or Position | INTERIM CEO
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Name | MR. RICHARD PRIORE
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Credential |
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Telephone | 985-690-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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