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Contact Information

SOUTHERN MEDICAL HOLDING CORPORATION
12133 INDUSTRIPLEX BLVD
BATON ROUGE, LA70809-5129
 Phone: 225-756-5239
 Fax: 225-752-2614
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist/Technologist Cardiovascular, Sonography

246XS1301X
Indicates primary specialty

NPI Profile & details for SOUTHERN MEDICAL HOLDING CORPORATION

NPI # 1558340083
LBN Legal business name SOUTHERN MEDICAL HOLDING CORPORATION
Authorized official DAVID MELANCON - (COO/CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 01/12/2006
Last updated 06/28/2013 - About 13 years ago
Identifiers
LA License # 170011032
LA Medicaid 1121894
MO Medicaid 506047901
LA Other C3563 BLUE CROSS PROV.NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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