Provider Demographics
NPI:1346961976
Name:EAGLE ONE LLLC
Entity Type:Organization
Organization Name:EAGLE ONE LLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONWER
Authorized Official - Prefix:MR
Authorized Official - First Name:THEOPHILUS SPEARS
Authorized Official - Middle Name:B
Authorized Official - Last Name:EAGLE ONE LLC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-616-5391
Mailing Address - Street 1:4121 SAINT CLAUDE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70117-5336
Mailing Address - Country:US
Mailing Address - Phone:504-616-5391
Mailing Address - Fax:
Practice Address - Street 1:6011 S MUIRFIELD CIR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70128-3656
Practice Address - Country:US
Practice Address - Phone:504-616-5391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty