Pediatric Specialty Clinic

LBN: Our Lady Of The Lake Hospital, Inc
Pediatric Specialty Clinic is an health care organization with primary practice located at 5000 Hennessy Blvd , Baton Rouge LA 70808-4375. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, which is considered as the primary health care specialty. Our Lady Of The Lake Hospital, Inc can be contacted via phone (225) 765-7163, or through Limbocker, Jeffery D. via phone (225) 765-6306.

Contact Information

Primary practice address
5000 Hennessy Blvd Baton Rouge LA 70808-4375
Phone: (225) 765-7163
Fax: (225) 765-7164
Website:
Map and Directions
Authorized official contact:
Name: Limbocker, Jeffery D.
Phone: (225) 765-6306

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 207PP0204X

Profile Details

NPI number 1093947905
LBN Legal business name Our Lady Of The Lake Hospital, Inc
DBA Doing business as Pediatric Specialty Clinic
Authorized official Limbocker, Jeffery D.
Entity Organization
Organization subpart 1 Yes
Enumeration date Aug 12th, 2009
Last updated Apr 15th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093947905 NPPES
Louisiana MEDICAID 1447129
Louisiana MEDICAID 08775372

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