Pediatrust Lake Charles, Llc

LBN: Pediatrust Lake Charles, Llc
Pediatrust Lake Charles, Llc is an health care organization with primary practice located at 4250 5Th Ave , Lake Charles LA 70607-3900. The organization recently has only one registered license in Managed Care Organizations / Exclusive Provider Organization, which is considered as the primary health care specialty. Pediatrust Lake Charles, Llc can be contacted via phone (337) 562-7818, or through Craig, Leann via phone (225) 252-7633.

Contact Information

Primary practice address
4250 5Th Ave Lake Charles LA 70607-3900
Phone: (337) 562-7818
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Craig, Leann
Phone: (225) 252-7633

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Exclusive Provider Organization 302F00000X 2203782281 Louisiana

Profile Details

NPI number 1518359165
LBN Legal business name Pediatrust Lake Charles, Llc
DBA Doing business as
Authorized official Craig, Leann
Entity Organization
Organization subpart 1 No
Enumeration date Feb 19th, 2015
Last updated Feb 19th, 2015 - about 9 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 1518359165 NPPES
Louisiana MEDICAID 2203782281

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