NPIMap

Organization Active NPI

Immunization Services of Louisiana, LLC

  • Community Health Clinic/Center
  • Metairie, LA
National Provider Identifier
1407120785
Registry record updated Mar 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
17258 Issued in LA
Legal business name
IMMUNIZATION SERVICES OF LOUISIANA, LLC
Practice address
1608 Division St
Metairie, LA 70001-2712
Phone
(504) 430-3397
Fax
(504) 828-7640
NPI assigned
Mar 3, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2012

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

Authorized official

Name
Dr. Gregory Gerard Hedrick, PHARMDNPI 1497943690
Title
Owner
Phone
(504) 430-3397

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 17258 LA Primary

Addresses

Primary practice location

1608 Division St
Metairie, LA 70001-2712

Mailing address

1608 Division St
Metairie, LA 70001-2712
Phone (504) 430-3397

National Provider Directory

National Provider Directory

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": "1330732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331510400000",
    "number": "1407120785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 DIVISION ST",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700012712",
            "telephone_number": "504-430-3397",
            "fax_number": "504-828-7640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 DIVISION ST",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700012712",
            "telephone_number": "504-430-3397",
            "fax_number": "504-828-7640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMUNIZATION SERVICES OF LOUISIANA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-03",
        "last_updated": "2012-03-12",
        "status": "A",
        "authorized_official_last_name": "HEDRICK",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "GERARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-430-3397",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "LA",
            "license": "17258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; 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.