NPIMap

Organization Active NPI

Malicorp

  • Home Health Agency
  • Tallulah, LA
National Provider Identifier
1003947045
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
4504110 Issued in LA
Legal business name
MALICORP
Practice address
722 Johnson St
Tallulah, LA 71282-4533
Phone
(318) 574-2229
Fax
(318) 574-2219
NPI assigned
Mar 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Mary Alice Fuselier
Title
C.E.O.
Phone
(337) 993-2005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 4504110 LA Primary

Addresses

Primary practice location

722 Johnson St
Tallulah, LA 71282-4533

Mailing address

100 Toulouse Dr
Lafayette, LA 70506-5132
Phone (337) 993-2005

Other identifiers 1

IdentifierTypeStateIssuer
1460753MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Malicorp11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203897600000",
    "number": "1003947045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 TOULOUSE DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705065132",
            "telephone_number": "337-993-2005",
            "fax_number": "337-993-2026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 JOHNSON ST",
            "city": "TALLULAH",
            "state": "LA",
            "postal_code": "712824533",
            "telephone_number": "318-574-2229",
            "fax_number": "318-574-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALICORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2008-02-25",
        "status": "A",
        "authorized_official_last_name": "FUSELIER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ALICE",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "337-993-2005",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "LA",
            "license": "4504110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1460753",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallulah, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.