Healthcare Provider Details

I. General information

NPI: 1831198175
Provider Name (Legal Business Name): GENESIS SPECIALTY HOSPITALS II, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N JEFFERSON DAVIS PKWY 4 TH FLOOR
NEW ORLEANS LA
70119-5311
US

IV. Provider business mailing address

3918 JACKSON STREET EXT
ALEXANDRIA LA
71303-3007
US

V. Phone/Fax

Practice location:
  • Phone: 504-486-5841
  • Fax: 504-485-5875
Mailing address:
  • Phone: 318-445-7344
  • Fax: 318-484-2865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number503
License Number StateLA

VIII. Authorized Official

Name: T G SMITH
Title or Position: C E O
Credential:
Phone: 318-445-7344