Healthcare Provider Details

I. General information

NPI: 1689977902
Provider Name (Legal Business Name): UNIVERSITY MEDICAL CENTER MANAGEMENT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2010
Last Update Date: 02/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 CANAL STREET
NEW ORLEANS LA
70112
US

IV. Provider business mailing address

2000 CANAL STREET
NEW ORLEANS LA
70112
US

V. Phone/Fax

Practice location:
  • Phone: 504-702-4434
  • Fax: 504-702-2118
Mailing address:
  • Phone: 504-702-4434
  • Fax: 504-702-2118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number191-E
License Number StateLA

VIII. Authorized Official

Name: GREGORY FEIM
Title or Position: CEO
Credential:
Phone: 504-702-4434