Organization
LIFETIME HEARING AIDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID SIMON BORDELON HIS (PRESIDENT)
(985) 726-0001
Entity
Organization
Contact information
Practice address
59401 SPRING DR, SLIDELL, LA 70461-5128
(985) 726-0001
Mailing address
59401 SPRING DR, SLIDELL, LA 70461-5128
(985) 726-0001
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
734
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1545716
LOUISIANA DEPT. OF HEALTH AND HOSPITALS
LA
Enumeration date
04/22/2008
Last updated
04/22/2008
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