NPIMap

Organization Active NPI

Lifeline Health Essentials LLC

  • Durable Medical Equipment & Medical Supplies
  • Marrero, LA
National Provider Identifier
1124568571
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
LIFELINE HEALTH ESSENTIALS LLC
Practice address
4700 Wichers Dr
Suite 201
Marrero, LA 70072-3041
Phone
(504) 758-4220
NPI assigned
Mar 6, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Iisha K Bailey, PHARMDNPI 1679888986
Title
Manager
Phone
(504) 758-4220

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Durable Medical Equipment & Medical Supplies 332B00000X LA Primary
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

4700 Wichers Dr
Suite 201
Marrero, LA 70072-3041

Mailing address

PO Box 2864
Harvey, LA 70059-2864
Phone (504) 758-4220

Other names 1

  • The Mastectomy Boutique Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211210001454 LA Part B Supplier - Mass Immunization (Roster Biller Only) 7719220995 Practice locations: Harvey, LA

National Provider Directory

National Provider Directory

Locations

3407 Lapalco Blvd
Ste 3
Harvey, LA 70058
Phone (504) 758-4220

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1488758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1124568571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2864",
            "city": "HARVEY",
            "state": "LA",
            "postal_code": "700592864",
            "telephone_number": "504-758-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WICHERS DR",
            "address_2": "SUITE 201",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723041",
            "telephone_number": "504-758-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE HEALTH ESSENTIALS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-06",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "IISHA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "504-758-4220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "LA",
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Mastectomy Boutique",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marrero, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.