Provider Demographics
NPI:1710036496
Name:GLOBAL MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:GLOBAL MEDICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:PEYROUX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:985-641-4898
Mailing Address - Street 1:PO BOX 1896
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70459-1896
Mailing Address - Country:US
Mailing Address - Phone:985-641-4898
Mailing Address - Fax:985-649-6512
Practice Address - Street 1:436 OLD SPANISH TRL
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-3904
Practice Address - Country:US
Practice Address - Phone:985-641-4898
Practice Address - Fax:985-641-8060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1089111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA6241930001Medicare NSC
LA5C842Medicare ID - Type UnspecifiedMEDICARE