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General NPI Number Information
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NPI Number | 1497090740
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Entity Type | Organization
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Legal Business Name | PONTCHARTRAIN SURGERY CENTER, LLC
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Dates
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Enumeration Date | 11/27/2012
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 4407 HIGHWAY 190 EAST SERVICE RD STE 200
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City | COVINGTON
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State | LA
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Zip | 70433-4957
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Country | US
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Telephone | 985-234-9700
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Fax | 985-234-9706
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Provider Business Mailing Address
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Address Line | 4407 HIGHWAY 190 EAST SERVICE RD STE 200
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City | COVINGTON
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State | LA
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Zip | 70433-4972
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Country | US
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Telephone | 985-234-9700
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Fax | 985-234-9706
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LISA SALMON
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Credential | RN
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Telephone | 985-234-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 157
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License Number State | LA
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