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General NPI Number Information
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NPI Number | 1154624468
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Entity Type | Organization
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Legal Business Name | MEDICAL CENTER OF LOUISIANA AT NEW ORLEANS
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Dates
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Enumeration Date | 12/08/2010
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Last Update Date | 12/08/2010
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Provider Practice Location Address
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Address Line | 725 VALLETTE ST
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City | NEW ORLEANS
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State | LA
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Zip | 70114-4347
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Country | US
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Telephone | 504-903-2373
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Fax |
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Provider Business Mailing Address
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Address Line | 2021 PERDIDO ST
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City | NEW ORLEANS
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State | LA
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Zip | 70112-1352
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Country | US
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Telephone | 504-903-5153
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Fax | 504-680-0203
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Authorized Official
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Title or Position | INTERIM CHIEF EXECUTIVE OFFICER
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Name | ROXANE A. TOWNSEND
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Credential | M.D.
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Telephone | 504-903-4907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 191-J
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License Number State | LA
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