Provider Demographics
NPI:1184204117
Name:NEW AGE MEDICAL SERVICES, LLC
Entity Type:Organization
Organization Name:NEW AGE MEDICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEEPESH
Authorized Official - Middle Name:RUBIN
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-224-8690
Mailing Address - Street 1:15550 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-6504
Mailing Address - Country:US
Mailing Address - Phone:225-224-8690
Mailing Address - Fax:225-615-7704
Practice Address - Street 1:15550 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-6504
Practice Address - Country:US
Practice Address - Phone:225-224-8690
Practice Address - Fax:225-615-7704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA43352006KOtherSTATE CHARTER NUMBER