Provider Demographics
NPI:1114944634
Name:MCMILLAN CORPORATION
Entity Type:Organization
Organization Name:MCMILLAN CORPORATION
Other - Org Name:ADVANCED HAND SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCMILLAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:985-674-4170
Mailing Address - Street 1:594 ASBURY DR
Mailing Address - Street 2:STE A
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-4101
Mailing Address - Country:US
Mailing Address - Phone:985-674-4170
Mailing Address - Fax:985-674-4172
Practice Address - Street 1:594 ASBURY DR
Practice Address - Street 2:STE A
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471
Practice Address - Country:US
Practice Address - Phone:985-674-4170
Practice Address - Fax:985-674-4172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CQ94OtherMEDICARE PROVIDER NUMBER/PTAN