Provider Demographics
NPI:1275787483
Name:MOBILE HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:MOBILE HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:MELANCON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-756-5239
Mailing Address - Street 1:12133 INDUSTRIPLEX BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-5129
Mailing Address - Country:US
Mailing Address - Phone:225-756-5239
Mailing Address - Fax:225-756-4556
Practice Address - Street 1:13311 LAWSON RD
Practice Address - Street 2:SUITE B
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72210-2601
Practice Address - Country:US
Practice Address - Phone:225-756-5239
Practice Address - Fax:225-756-4556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-14
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory