Provider Demographics
NPI:1760156418
Name:NATIONAL HANSEN'S DISEASE PROGRAM (NHDP)
Entity Type:Organization
Organization Name:NATIONAL HANSEN'S DISEASE PROGRAM (NHDP)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, NHDP
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:TRACY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:225-756-3771
Mailing Address - Street 1:9181 INTERLINE AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-1900
Mailing Address - Country:US
Mailing Address - Phone:800-642-2477
Mailing Address - Fax:225-756-3706
Practice Address - Street 1:9181 INTERLINE AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-1900
Practice Address - Country:US
Practice Address - Phone:800-642-2477
Practice Address - Fax:225-756-3706
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH RESOURCES AND SERVICES ADMINISTRATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0904XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, Federal
No333600000XSuppliersPharmacy