Provider Demographics
NPI:1326114364
Name:ACADIANA ENDOSCOPY CENTER, INC.
Entity Type:Organization
Organization Name:ACADIANA ENDOSCOPY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SALVATIERRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-269-1126
Mailing Address - Street 1:443 HEYMANN BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2632
Mailing Address - Country:US
Mailing Address - Phone:337-269-1126
Mailing Address - Fax:337-269-1476
Practice Address - Street 1:443 HEYMANN BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2632
Practice Address - Country:US
Practice Address - Phone:337-269-1126
Practice Address - Fax:337-269-1476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA173261QE0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1956961Medicaid
LA1956961Medicaid
LA11046Medicare ID - Type UnspecifiedMEDICARE NUMBER