Provider Demographics
NPI:1083832935
Name:PAYNE'S HOME CARE SERVICE, INC
Entity Type:Organization
Organization Name:PAYNE'S HOME CARE SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:C
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-444-4131
Mailing Address - Street 1:P.O. BOX 13321
Mailing Address - Street 2:7829 FIG STREET
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70185-3321
Mailing Address - Country:US
Mailing Address - Phone:504-865-8142
Mailing Address - Fax:504-866-4775
Practice Address - Street 1:7829 FIG STREET
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125
Practice Address - Country:US
Practice Address - Phone:504-865-8142
Practice Address - Fax:504-866-4775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7178305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1695726OtherPCA