Provider Demographics
NPI:1528344694
Name:LEXMARK HEALTH CARE, LLC
Entity type:Organization
Organization Name:LEXMARK HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MORAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-894-8904
Mailing Address - Street 1:PO BOX 5610
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70469-5610
Mailing Address - Country:US
Mailing Address - Phone:504-894-8904
Mailing Address - Fax:504-894-8950
Practice Address - Street 1:3525 PRYTANIA ST
Practice Address - Street 2:STE 425
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3500
Practice Address - Country:US
Practice Address - Phone:504-899-2441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1138251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health