Provider Demographics
NPI:1841782208
Name:JOURNEY MEDICAL LLC
Entity Type:Organization
Organization Name:JOURNEY MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HECTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-218-4677
Mailing Address - Street 1:12025 JUSTICE AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-5327
Mailing Address - Country:US
Mailing Address - Phone:225-218-4677
Mailing Address - Fax:225-218-4677
Practice Address - Street 1:11924 JUSTICE AVE STE B
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-2372
Practice Address - Country:US
Practice Address - Phone:225-218-4677
Practice Address - Fax:225-218-4677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-01
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA301823246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty