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NPI Code Detail

MEDICARE: MHSD

MEDICARE: MHSD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1302R00000XHealth Maintenance Organization30LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
130OTHERLAMANAGED CARE ORGANIZATION

General Provider Information

NPI Number : 1033474655
Entity Type Code : Organization
Provider Name (Legal Business Name) : MHSD
Provider Business Mailing Address
First Line : 4222 GEN. MEYER AVE.
Second Line : STE. 100
City : N.O.
State : LA
Zip : 70131
Country : US
Telephone Number : 504-361-6092
Fax Number : 504-361-6256
Provider Business Practice Location Address
First Line : 3710 RUE DELPHINE
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70131-7241
Country : US
Telephone Number : 504-361-6092
Fax Number : 504-361-6256
Authorized Official
Title or Position : CLINICAL NURSE
Name : MRS. VANESSA MARIE WILSON
Credential : RN
Telephone Number : 504-361-6092
Provider Enumeration Date : 07/10/2012
Last Update Date : 07/10/2012

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Directions to “MHSD ” Practice Location

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