Provider Demographics
NPI:1730213158
Name:REDDI CARE AMBULATORY CLINIC, LLC
Entity type:Organization
Organization Name:REDDI CARE AMBULATORY CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-355-5940
Mailing Address - Street 1:5525 AIRLINE HWY
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70805-2402
Mailing Address - Country:US
Mailing Address - Phone:225-355-5940
Mailing Address - Fax:225-359-3195
Practice Address - Street 1:5525 AIRLINE HWY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70805-2402
Practice Address - Country:US
Practice Address - Phone:225-355-5940
Practice Address - Fax:225-359-3195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty