Healthcare Provider Details

I. General information

NPI: 1538123435
Provider Name (Legal Business Name): NAVAL AMBULATORY CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 08/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 GENERAL MEYER AVE. BLDG H100
NEW ORLEANS LA
70142-0001
US

IV. Provider business mailing address

2300 GENERAL MEYER AVE. BLDG H100
NEW ORLEANS LA
70142-0001
US

V. Phone/Fax

Practice location:
  • Phone: 504-678-2400
  • Fax:
Mailing address:
  • Phone: 504-678-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1100X
TaxonomyMilitary/U.S. Coast Guard Outpatient Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES L. AYERS
Title or Position: DIRECTOR, RESOURCE MANAGEMENT
Credential:
Phone: 850-505-6309