SOUTHERN MEDICAL HOLDING CORPORATION (NPI# 1558340083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1558340083 |
Entity Type | Organization |
Organization Name | SOUTHERN MEDICAL HOLDING CORPORATION |
Other Organization Name | SOUTHERN MEDICAL CORPORATION |
Practice Address |
12133 Industriplex Blvd Baton Rouge LA 70809-5129 |
Practice Telephone | 2257565239 |
Practice Fax Number | 2257522614 |
Mailing Telephone | 2257565239 |
Mailing Fax Number | 2257522614 |
Enumeration Date | 2006-01-12 |
Last Update Date | 2013-06-28 |
Authorized Official Name | MR. DAVID P MELANCON (COO/CFO) |
Authorized Official Telephone | 2257565239 |
Authorized Official Credential | CPA, MBA |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 246XS1301X |
Spec/Tech, Cardiovascular Specialization: Sonography |
170011032 | LA | Technologists, Technicians & Other Technical Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | 506047901 | 05 | |
LA | BLUE CROSS PROV.NUMBER | C3563 | 01 |
LA | 1121894 | 05 |
Other Name | Type Code |
---|---|
Southern Medical Corporation | Doing Business As Name - Organization |
Street Address |
12133 INDUSTRIPLEX BLVD |
City | BATON ROUGE |
State | LA |
Zip Code | 70809-5129 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952555161 | American Diagnostic Technologies, LLC | Physiological Laboratory | 12133 Industriplex Blvd, Baton Rouge, LA 70809-5129 | 2008-11-14 |
1215009436 | Wnf Medical, LLC | Durable Medical Equipment & Medical Supplies | 12133 Industriplex Blvd, Baton Rouge, LA 70809-5129 | 2006-11-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619582640 | Lisha Kerr Jacobsen | Counselor | 7936 Wrenwood Drive, Bldg # A, Baton Rouge, LA 70809 | 2020-09-15 |
1790301596 | Louisiana Regenerative Medicine Center | Clinic/Center | 9456 Jefferson Hwy St A, Baton Rouge, LA 70809 | 2020-06-18 |
1093337305 | Sew Luxe Customs, LLC | Prosthetic/Orthotic Supplier | 8674 Quarters Lake Road, Building 11 Suit 1, Baton Rouge, LA 70809 | 2020-05-08 |
1366903908 | Tamika Wyna Piper | Counselor | 11445 Reiger Road, Baton Rouge, LA 70809 | 2019-03-27 |
1548734213 | Urg-hab Surgical Specialists | Pain Medicine | 8558 Jefferson Hwy, Baton Rouge, LA 70809 | 2019-01-16 |
1205306610 | Monique West | Case Manager/Care Coordinator | 9441 Common Street, Suite B, Baton Rouge, LA 70809 | 2018-11-28 |
1679061618 | Sara Elizabeth Nicole Altaean | Massage Therapist | Ability Massage & Day Spa, 7656 Jefferson Hwy Suite 1a, Baton Rouge, LA 70809 | 2018-04-25 |
1871098921 | Gary Bernard Jr. | Massage Therapist | 7656 Jefferson Hwy Suite 1a, Baton Rouge, LA 70809 | 2018-03-29 |
1619476355 | De'andria Banks | Behavior Technician | 9150 Bareford Drive, Baton Rouge, LA 70809 | 2018-02-08 |
1427561679 | Angiogenesis Medical LLC | Durable Medical Equipment & Medical Supplies | 8032 Summa Ave Ste D, Baton Rouge, LA 70809 | 2017-11-09 |
Find all providers in zip 70809 |
Taxonomy Code | 246XS1301X |
Grouping | Technologists, Technicians & Other Technical Service Providers |
Classification | Spec/Tech, Cardiovascular |
Specialization | Sonography |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447790670 | Sound Health Diagnostics | Spec/Tech, Cardiovascular | 2224 Morningbrook Dr, Baton Rouge, LA 70816-3437 | 2017-03-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477098317 | Seesound Technologies, LLC | Spec/Tech, Cardiovascular | 1920 General Taylor St, New Orleans, LA 70115-5350 | 2017-01-02 |
1952784043 | Kyle Hayes | Spec/Tech, Cardiovascular | 315 Walker Gravel Pit Rd, Dry Prong, LA 71423-3651 | 2015-07-07 |
1184977753 | Samuel Tournillon IIi | Spec/Tech, Cardiovascular | 229 Evangeline Dr, Mandeville, LA 70471-1856 | 2012-10-19 |
1053618280 | Precision Imaging, LLC | Spec/Tech, Cardiovascular | 489 Secluded Grove Loop, Madisonville, LA 70447-3331 | 2011-02-24 |
1417250846 | Kevin J Tate | Spec/Tech, Cardiovascular | 335 Grant Rd, Opelousas, LA 70570-0745 | 2010-12-07 |
1366767071 | Jennifer Evans | Spec/Tech, Cardiovascular | 275 Clinton Dr, Stonewall, LA 71078-5405 | 2010-04-06 |
1336345693 | Gordon A Lee | Spec/Tech, Cardiovascular | 451 Elmwood St, Shreveport, LA 71104-5009 | 2007-06-25 |
1538549407 | Brandie Hidalgo Anderson | Spec/Tech, Cardiovascular | 110 Hospital Dr, Lafayette, LA 70503-2819 | 2015-06-04 |
1831417823 | Quality Mobile Ultrasound LLC | Spec/Tech, Cardiovascular | 275 Clinton Dr, Stonewall, LA 71078-5405 | 2010-05-14 |
1124357504 | Pinnacle Medical Services, Inc. | Spec/Tech, Cardiovascular | 72108 Ramos Ave, Suite A, Covington, LA 70433-9501 | 2009-12-15 |
Find all providers with the same taxonomy |
City | BATON ROUGE |
Zip Code | 70809 |
Please comment or provide details below to improve the information on SOUTHERN MEDICAL HOLDING CORPORATION.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.