Provider Demographics
NPI:1144325127
Name:JRS PATHOLOGY LLC
Entity type:Organization
Organization Name:JRS PATHOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:F
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-841-9522
Mailing Address - Street 1:PO BOX 1907
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70054-1907
Mailing Address - Country:US
Mailing Address - Phone:504-361-3757
Mailing Address - Fax:504-361-3132
Practice Address - Street 1:1141 WHITNEY AVE # 3
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-5011
Practice Address - Country:US
Practice Address - Phone:504-361-3757
Practice Address - Fax:504-361-3132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5N741Medicare PIN
LAF05622Medicare UPIN