Provider Demographics
NPI:1326013145
Name:LOUISIANA OCCUPATIONAL HEALTH SERVICES
Entity Type:Organization
Organization Name:LOUISIANA OCCUPATIONAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDERHOEVEN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA-HCA
Authorized Official - Phone:318-561-8200
Mailing Address - Street 1:3018 JACKSON STREET, SUITE 100
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301
Mailing Address - Country:US
Mailing Address - Phone:318-561-8200
Mailing Address - Fax:318-561-8204
Practice Address - Street 1:3018 JACKSON STREET, SUITE 100
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301
Practice Address - Country:US
Practice Address - Phone:318-561-8200
Practice Address - Fax:318-561-8204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA016138305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service