Provider Demographics
NPI:1639243520
Name:AMERICAN LUNG ASSOCIATION OF LOUISIANA,
Entity Type:Organization
Organization Name:AMERICAN LUNG ASSOCIATION OF LOUISIANA,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:LOTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MED, RRT
Authorized Official - Phone:504-828-5864
Mailing Address - Street 1:2325 SEVERN AVE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-6918
Mailing Address - Country:US
Mailing Address - Phone:504-828-5864
Mailing Address - Fax:504-828-5867
Practice Address - Street 1:2325 SEVERN AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-6918
Practice Address - Country:US
Practice Address - Phone:504-828-5864
Practice Address - Fax:504-828-5867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA10530Medicare ID - Type Unspecified