Healthcare Provider Details

I. General information

NPI: 1285702977
Provider Name (Legal Business Name): JEFFERSON PARISH HOSPITAL SERVICE DISTRICT #1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 05/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 MEDICAL CENTER BLVD
MARRERO LA
70072-3147
US

IV. Provider business mailing address

1101 MEDICAL CENTER BLVD
MARRERO LA
70072-3147
US

V. Phone/Fax

Practice location:
  • Phone: 504-349-1383
  • Fax: 504-349-1334
Mailing address:
  • Phone: 504-349-1383
  • Fax: 504-349-1334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number236
License Number StateLA

VIII. Authorized Official

Name: MS. MARY SONIER
Title or Position: DIRECTOR PATIENT BUSINESS SERVICES
Credential:
Phone: 504-349-1383