Medicl Facility ID: 12874925933763820811

Facility Business Name: OLOL PONTCHARTRAIN SURGERY CENTER LLC DBA OUR LADY OF THE LAKE PONTCHARTRAIN SURGERY CENTER ( COVINGTON, LA )

A list of all facilities registered with Medicare that includes addresses and phone numbers.

Field Name	Field Value
Facility Id	12874925933763820811
Facility Name	OLOL PONTCHARTRAIN SURGERY CENTER LLC DBA OUR LADY OF THE LAKE PONTCHARTRAIN SURGERY CENTER
Address Line	4407 HIGHWAY 190 EAST SERVICE RD
City	COVINGTON
State	LA
Zip	70433
Type	Hospital
NPI Number	1497090740
Provider Id	19C0001113