Provider Demographics
NPI:1881677441
Name:LOUIS C HERRING & CO
Entity Type:Organization
Organization Name:LOUIS C HERRING & CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-841-6770
Mailing Address - Street 1:PO BOX 2191
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32802-2191
Mailing Address - Country:US
Mailing Address - Phone:407-841-6770
Mailing Address - Fax:407-422-8896
Practice Address - Street 1:1111 S ORANGE AVE FL 2
Practice Address - Street 2:LEVEL 2
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1236
Practice Address - Country:US
Practice Address - Phone:407-841-6770
Practice Address - Fax:407-422-8896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-28
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL800000126291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLL800000126OtherFLORIDA LAB LICENSE NUMBE
FL0300161-00Medicaid
FLL800000126OtherFLORIDA LAB LICENSE NUMBE