Provider Demographics
NPI:1528225794
Name:ADMINISTRATORS OF THE TULANE EDUCATIONAL FUND
Entity Type:Organization
Organization Name:ADMINISTRATORS OF THE TULANE EDUCATIONAL FUND
Other - Org Name:TULANE UNIVERSITY MEDICAL GROUP MOBILE UNIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIR., TULANE UNIV. BUSINESS SERVICE
Authorized Official - Prefix:MRS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-988-3587
Mailing Address - Street 1:1430 TULANE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2632
Mailing Address - Country:US
Mailing Address - Phone:504-988-2300
Mailing Address - Fax:504-988-3969
Practice Address - Street 1:1430 TULANE AVE # SL37
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2632
Practice Address - Country:US
Practice Address - Phone:504-988-2300
Practice Address - Fax:504-988-3969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1360538Medicaid