Provider Demographics
NPI:1679683403
Name:VASCULAR ASSOCIATES LABORATORY
Entity Type:Organization
Organization Name:VASCULAR ASSOCIATES LABORATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:H
Authorized Official - Last Name:VARNADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-769-4493
Mailing Address - Street 1:8595 PICARDY AVENUE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3675
Mailing Address - Country:US
Mailing Address - Phone:225-769-4266
Mailing Address - Fax:225-819-2976
Practice Address - Street 1:8595 PICARDY AVENUE
Practice Address - Street 2:SUITE 320
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3675
Practice Address - Country:US
Practice Address - Phone:225-769-4266
Practice Address - Fax:225-819-2976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1445843Medicaid
5C443Medicare ID - Type Unspecified