Provider Demographics
NPI:1295024222
Name:LOURDES IMAGING CENTER LLC
Entity Type:Organization
Organization Name:LOURDES IMAGING CENTER LLC
Other - Org Name:LOURDES IMAGING NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:L
Authorized Official - Last Name:HEBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-289-2000
Mailing Address - Street 1:4809 AMBASSADOR CAFFERY PARKWAY
Mailing Address - Street 2:SUITE 350
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508
Mailing Address - Country:US
Mailing Address - Phone:337-231-5775
Mailing Address - Fax:
Practice Address - Street 1:4809 AMBASSADOR CAFFERY PARKWAY
Practice Address - Street 2:SUITE 350
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508
Practice Address - Country:US
Practice Address - Phone:337-231-5775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOURDES IMAGING CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty