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NPI Code Detail

MEDICARE: MR. DAMIEN TEAGUE SR.

MEDICARE:  MR. DAMIEN  TEAGUE SR.
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
13416L0300XLand Ambulance

General Provider Information

NPI Number : 1689255457
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAMIEN TEAGUE SR.
Provider Business Mailing Address
First Line : 7836 BASS ST
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70128-1739
Country : US
Telephone Number : 504-547-4790
Fax Number :
Provider Business Practice Location Address
First Line : 7836 BASS ST
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70128-1739
Country : US
Telephone Number : 504-547-4790
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2021
Last Update Date : 04/14/2021

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Directions to “ MR. DAMIEN TEAGUE SR. ” Practice Location

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