Provider Demographics
NPI:1043968068
Name:ARK DIVERSIFIED HEALTHCARE SOLUTIONS
Entity type:Organization
Organization Name:ARK DIVERSIFIED HEALTHCARE SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:ELISE
Authorized Official - Last Name:KOGER
Authorized Official - Suffix:
Authorized Official - Credentials:LAB DIRECTOR
Authorized Official - Phone:985-200-1092
Mailing Address - Street 1:1000 N MORRISON BLVD UNIT 2
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401-2233
Mailing Address - Country:US
Mailing Address - Phone:985-200-1092
Mailing Address - Fax:
Practice Address - Street 1:1000 N MORRISON BLVD STE 2
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-2233
Practice Address - Country:US
Practice Address - Phone:985-200-1092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-17
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory