Provider Demographics
NPI:1649031873
Name:HAMMOND, LONNIE EDWARD III
Entity type:Individual
Prefix:
First Name:LONNIE
Middle Name:EDWARD
Last Name:HAMMOND
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 LOYOLA AVE UNIT 58437
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70158-5019
Mailing Address - Country:US
Mailing Address - Phone:504-315-3674
Mailing Address - Fax:504-315-3673
Practice Address - Street 1:3963 N FOSTER DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70805-5222
Practice Address - Country:US
Practice Address - Phone:504-315-3674
Practice Address - Fax:504-315-3673
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA342000000X
311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No342000000XTransportation ServicesTransportation Network Company