Provider Demographics
NPI:1255388088
Name:JANET OKEKE
Entity type:Organization
Organization Name:JANET OKEKE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:OKEKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-439-2290
Mailing Address - Street 1:1800 BROAD ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-4659
Mailing Address - Country:US
Mailing Address - Phone:337-439-2290
Mailing Address - Fax:
Practice Address - Street 1:1800 BROAD ST
Practice Address - Street 2:SUITE B
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-4659
Practice Address - Country:US
Practice Address - Phone:337-439-2290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4278230001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies