1578754693 NPI number — CATHERINE JOHNSON RICHE MD

Table of content: CATHERINE JOHNSON RICHE MD (NPI 1578754693)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578754693 NPI number — CATHERINE JOHNSON RICHE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RICHE
Provider First Name:
CATHERINE
Provider Middle Name:
JOHNSON
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JOHNSON
Provider Other First Name:
CATHERINE
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1578754693
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/17/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8080 BLUEBONNET BLVD
Provider Second Line Business Mailing Address:
SUITE 1000
Provider Business Mailing Address City Name:
BATON ROUGE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70810-7827
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-408-7864
Provider Business Mailing Address Fax Number:
225-408-7854

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8080 BLUEBONNET BLVD
Provider Second Line Business Practice Location Address:
SUITE 1000
Provider Business Practice Location Address City Name:
BATON ROUGE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70810-7827
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-408-7864
Provider Business Practice Location Address Fax Number:
225-408-7854
Provider Enumeration Date:
08/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  202738 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1923885 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8AD831 . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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