Provider Demographics
NPI:1003848334
Name:LAUDER ENTERPRISES, INC
Entity Type:Organization
Organization Name:LAUDER ENTERPRISES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:K
Authorized Official - Last Name:LAUDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-388-8642
Mailing Address - Street 1:PO BOX 780249
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78278-0249
Mailing Address - Country:US
Mailing Address - Phone:800-388-8642
Mailing Address - Fax:210-492-1584
Practice Address - Street 1:4754 SHAVANO OAK
Practice Address - Street 2:SUITE 104
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-4009
Practice Address - Country:US
Practice Address - Phone:800-388-8642
Practice Address - Fax:210-492-1584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0588230001Medicare NSC