Provider Demographics
NPI:1811035017
Name:LOUISIANA CARDIAC IMAGING LLC
Entity Type:Organization
Organization Name:LOUISIANA CARDIAC IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:SADIA
Authorized Official - Middle Name:
Authorized Official - Last Name:QAMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-728-9486
Mailing Address - Street 1:HWY 250 3048
Mailing Address - Street 2:
Mailing Address - City:RAYVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71269-3624
Mailing Address - Country:US
Mailing Address - Phone:318-728-9486
Mailing Address - Fax:318-728-9488
Practice Address - Street 1:HWY 250 3048
Practice Address - Street 2:3048
Practice Address - City:RAYVILLE
Practice Address - State:LA
Practice Address - Zip Code:71269-3624
Practice Address - Country:US
Practice Address - Phone:318-728-9486
Practice Address - Fax:318-728-9488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1447897Medicaid
LA5DA02Medicare PIN