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NPI Code Detail

MEDICARE: OAC LLC

MEDICARE: OAC LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1282N00000XGeneral Acute Care Hospital

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1190061363ZOTHERLABLUE CROSS OF LA

General Provider Information

NPI Number : 1366411662
Entity Type Code : Organization
Provider Name (Legal Business Name) : OAC LLC
Provider Business Mailing Address
First Line : 5130 MANCUSO LANE
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-3583
Country : US
Telephone Number : 225-766-5001
Fax Number : 225-766-5001
Provider Business Practice Location Address
First Line : 5130 MANCUSO LANE
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-3583
Country : US
Telephone Number : 225-766-5001
Fax Number : 225-766-5001
Authorized Official
Title or Position : BUSINESS OFFICE DIRECTOR VITALSOURC
Name : MS. JULIE ALLEN-TULLIER
Credential :
Telephone Number : 225-766-5001
Provider Enumeration Date : 03/17/2006
Last Update Date : 01/12/2009

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Directions to “OAC LLC ” Practice Location

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