Provider Type Icon

PELICAN PHYSICIAN SERVICES LLC NPI 1851609978


NPI Information

NPI: 1851609978
Provider Name: PELICAN PHYSICIAN SERVICES, LLC
Classification: Emergency Medicine - 207PE0004X
Entity Type: Organization

Specialization: Emergency Medical Services

Address:
2375 GAUSE BLVD E
SLIDELL, LA
ZIP 70461
Phone: (985) 645-9000
Get Directions

PELICAN PHYSICIAN SERVICES, LLC is an emergency medical services emergency medicine in Slidell, LA. The provider is an emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. PELICAN PHYSICIAN SERVICES, LLC NPI is 1851609978. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2375 GAUSE BLVD E
SLIDELL, LA
ZIP 70461-142
Phone: (985) 645-9000
Fax: (985) 645-0359

The provider's authorized official is Kumar Kishore Amaraneni .
The authorized official title is Owner/registered Agent and has the following contact phone number (985) 645-9000.

The enumeration date for this NPI number is 9/23/2010 and was last updated on 7/9/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine019740LOUISIANANo
2207R00000XInternal Medicine025659LOUISIANANo
3208000000XPediatrics025659LOUISIANANo
4207PE0004XEmergency MedicineEmergency Medical Services06512RLOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15C676MEDICARE PINLOUISIANA
21442119MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.