Provider Demographics
NPI:1235495136
Name:B.A.T. COLLECTIONS SERVICE LLC
Entity Type:Organization
Organization Name:B.A.T. COLLECTIONS SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALISA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-509-8165
Mailing Address - Street 1:2105 JUSTICE ST. STE.B
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201
Mailing Address - Country:US
Mailing Address - Phone:318-509-8165
Mailing Address - Fax:318-509-8364
Practice Address - Street 1:2105 JUSTICE ST STE B
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-3602
Practice Address - Country:US
Practice Address - Phone:318-509-8165
Practice Address - Fax:318-509-8364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-04
Last Update Date:2012-10-17
Deactivation Date:2012-09-25
Deactivation Code:
Reactivation Date:2012-10-17
Provider Licenses
StateLicense IDTaxonomies
LA099157291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory