Provider Demographics
NPI:1619303773
Name:NORTH OAKS MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:NORTH OAKS MEDICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. V.P. / C.F.O.
Authorized Official - Prefix:MS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HSING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-230-6655
Mailing Address - Street 1:PO BOX 1609
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70404-1609
Mailing Address - Country:US
Mailing Address - Phone:985-230-6424
Mailing Address - Fax:985-230-6652
Practice Address - Street 1:15790 PAUL VEGA MD DR
Practice Address - Street 2:OUTSOURCING LABORATORY
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1434
Practice Address - Country:US
Practice Address - Phone:985-230-6165
Practice Address - Fax:985-230-6485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-20
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA000291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA19D0048399OtherCLIA
LA19D2020405OtherCLIA
LA1720267Medicaid
LA19D2020405OtherCLIA