MEDICARE: CHAPITAL CARDIOLOGY CLINIC L.L.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	014623	LA

General Provider Information

NPI Number	:	1902069586
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAPITAL CARDIOLOGY CLINIC L.L.C.

Provider Business Mailing Address
First Line	:	1221 N BROAD ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70119-3302
Country	:	US
Telephone Number	:	504-482-9755
Fax Number	:	504-482-9844

Provider Business Practice Location Address
First Line	:	1221 N BROAD ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70119-3302
Country	:	US
Telephone Number	:	504-482-9755
Fax Number	:	504-482-9844

Authorized Official
Title or Position	:	CEO
Name	:	DR. EMMETT BERNARD CHAPITAL JR.
Credential	:	M.D., MBA
Telephone Number	:	504-482-9755

Provider Enumeration Date	:	07/03/2008
Last Update Date	:	07/03/2008

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