Provider Demographics
NPI:1003976176
Name:SONO TECH ENTERPRISES, INC.
Entity Type:Organization
Organization Name:SONO TECH ENTERPRISES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-228-9895
Mailing Address - Street 1:PO BOX 24447
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70184-4447
Mailing Address - Country:US
Mailing Address - Phone:504-228-9895
Mailing Address - Fax:504-355-1041
Practice Address - Street 1:521 6TH ST
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-6039
Practice Address - Country:US
Practice Address - Phone:504-228-9895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA=========0OtherBLUE CROSS
LA5F960Medicare ID - Type Unspecified