Provider Demographics
NPI:1407161250
Name:NES LOUISIANA INC
Entity Type:Organization
Organization Name:NES LOUISIANA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-435-4591
Mailing Address - Street 1:PO BOX 402465
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-2465
Mailing Address - Country:US
Mailing Address - Phone:304-377-8721
Mailing Address - Fax:304-697-1155
Practice Address - Street 1:1900 MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLINTON
Practice Address - State:LA
Practice Address - Zip Code:70438-3688
Practice Address - Country:US
Practice Address - Phone:985-839-4431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-17
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS08502898Medicaid
LA2142321Medicaid
DR4129OtherRR MEDICARE
LA1900G6438ZOtherBCBS
LA5DT29Medicare PIN