Provider Demographics
NPI:1790042927
Name:LOUANGE SERVICES INC
Entity Type:Organization
Organization Name:LOUANGE SERVICES INC
Other - Org Name:LOUANGE TRANSPORT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AYODEJI
Authorized Official - Middle Name:
Authorized Official - Last Name:OWOYOMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-992-8437
Mailing Address - Street 1:3270 MOON BEAM CT
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-6130
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3270 MOON BEAM CT
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-6130
Practice Address - Country:US
Practice Address - Phone:404-992-8437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOUANGE REHAB SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)