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General NPI Number Information
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NPI Number | 1245880632
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Entity Type | Organization
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Legal Business Name | ALLIANCE MEDICAL CENTER LLC
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Dates
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Enumeration Date | 09/17/2019
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Last Update Date | 10/27/2020
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Provider Practice Location Address
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Address Line | 2520 HARVARD AVE # 2B
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City | METAIRIE
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State | LA
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Zip | 70001-1172
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Country | US
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Telephone | 504-533-8643
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Fax |
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Provider Business Mailing Address
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Address Line | 201 SAINT CHARLES AVE # 114-206
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City | NEW ORLEANS
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State | LA
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Zip | 70170-1000
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Country | US
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Telephone | 504-533-8643
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Fax |
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Authorized Official
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Title or Position | COMPLIANCE OFFICER
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Name | PAUL LEA
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Credential | COMPLIANCE OFFICER
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Telephone | 504-533-8643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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