Provider Demographics
NPI:1609425818
Name:S2 MEDICAL CORP
Entity Type:Organization
Organization Name:S2 MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACI
Authorized Official - Middle Name:
Authorized Official - Last Name:PITARRO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:985-517-0958
Mailing Address - Street 1:43174 N LITTLE ITALY RD
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-6404
Mailing Address - Country:US
Mailing Address - Phone:985-517-0958
Mailing Address - Fax:985-781-4319
Practice Address - Street 1:500 RUE DE SANTE
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-5418
Practice Address - Country:US
Practice Address - Phone:985-303-2327
Practice Address - Fax:985-781-4319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-10
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty