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NPI Code Detail

MEDICARE: MR. BENJAMIN A. SALDIVAR HIS

MEDICARE: MR. BENJAMIN A. SALDIVAR HIS
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
1237700000XHearing Instrument Specialist1211LA

General Provider Information

NPI Number : 1821494618
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BENJAMIN A. SALDIVAR HIS
Provider Business Mailing Address
First Line : 4273 NORTH BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-3914
Country : US
Telephone Number : 225-387-3208
Fax Number : 225-387-3266
Provider Business Practice Location Address
First Line : 4273 NORTH BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-3914
Country : US
Telephone Number : 225-387-3208
Fax Number : 225-387-3266
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2014
Last Update Date : 11/06/2014

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