Provider Demographics
NPI:1538441860
Name:LANDREAU INC
Entity type:Organization
Organization Name:LANDREAU INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CIDNEY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:LANDREAU
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:706-234-2001
Mailing Address - Street 1:3 CENTRAL PLZ
Mailing Address - Street 2:SUITE 215
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-3233
Mailing Address - Country:US
Mailing Address - Phone:706-234-2001
Mailing Address - Fax:706-234-2001
Practice Address - Street 1:14B PROFESSIONAL CT SW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-2832
Practice Address - Country:US
Practice Address - Phone:706-234-2001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAHADS000816261QH0700X
GAHADS000824261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech