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General NPI Number Information
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NPI Number | 1295410546
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Entity Type | Organization
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Legal Business Name | VICARE NOLA LLC
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Dates
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Enumeration Date | 06/15/2023
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 315 WESTBANK EXPY
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City | GRETNA
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State | LA
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Zip | 70053-5616
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Country | US
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Telephone | 504-364-1844
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Fax |
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Provider Business Mailing Address
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Address Line | 315 WESTBANK EXPY
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City | GRETNA
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State | LA
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Zip | 70053-5616
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. HAI NGUYEN
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Credential | MD
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Telephone | 504-939-1543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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