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General NPI Number Information
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NPI Number | 1134353642
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Entity Type | Organization
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Legal Business Name | SOUTHERN SURGICAL ASSIST, LLC
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Dates
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Enumeration Date | 05/12/2009
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Last Update Date | 11/08/2010
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Provider Practice Location Address
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Address Line | 1113 LINWOOD AVE
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City | METAIRIE
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State | LA
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Zip | 70003-2309
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Country | US
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Telephone | 504-460-9945
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Fax | 504-264-7434
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Provider Business Mailing Address
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Address Line | 1113 LINWOOD AVE
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City | METAIRIE
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State | LA
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Zip | 70003-2309
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Country | US
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Telephone | 504-460-9945
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Fax | 504-264-7434
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Authorized Official
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Title or Position | RNFA
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Name | MEGAN CATHERINE HINTZ
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Credential | RNFA
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Telephone | 504-460-9945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | 112468
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License Number State | LA
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