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General NPI Number Information
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NPI Number | 1750584397
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Entity Type | Organization
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Legal Business Name | LA DHH-OPH-IMMUNIZATION PROGRAM
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1450 L AND A RD
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City | METAIRIE
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State | LA
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Zip | 70001-6235
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Country | US
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Telephone | 504-838-5300
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Fax | 504-838-5206
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Provider Business Mailing Address
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Address Line | 1450 L AND A RD
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City | METAIRIE
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State | LA
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Zip | 70001-6235
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Country | US
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Telephone | 504-838-5300
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Fax | 504-838-5206
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Authorized Official
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Title or Position | IMMUNIZATION PROGRAM DIRECTOR
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Name | MR. RUBEN A TAPIA
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Credential | MPH
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Telephone | 504-838-5300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State | LA
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