Provider Demographics
NPI:1366892242
Name:LAZARUS SERVICES, LLC
Entity type:Organization
Organization Name:LAZARUS SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSTAFA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-557-2323
Mailing Address - Street 1:2239 POYDRAS ST STE 217
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-7561
Mailing Address - Country:US
Mailing Address - Phone:504-882-9112
Mailing Address - Fax:504-323-1056
Practice Address - Street 1:2239 POYDRAS ST
Practice Address - Street 2:SUITE 217
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-7561
Practice Address - Country:US
Practice Address - Phone:504-882-9112
Practice Address - Fax:504-323-1056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-21
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory