Provider Demographics
NPI:1689870388
Name:LES GALERIES VISUELLES
Entity Type:Organization
Organization Name:LES GALERIES VISUELLES
Other - Org Name:LGV LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER CEO
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:F
Authorized Official - Last Name:ARDOIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-876-0431
Mailing Address - Street 1:603 DUNN ST
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360
Mailing Address - Country:US
Mailing Address - Phone:985-876-0431
Mailing Address - Fax:985-876-6975
Practice Address - Street 1:603 DUNN ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360
Practice Address - Country:US
Practice Address - Phone:985-876-0431
Practice Address - Fax:985-876-6975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOC09014332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1075760001Medicare ID - Type Unspecified