MEDICARE: PEDIATRICS KID-MED, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	261Q00000X	Clinic/Center	LA
2	208000000X	Pediatrics Physician
3	2080N0001X	Neonatal-Perinatal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386626356
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDIATRICS KID-MED, LLC

Provider Business Mailing Address
First Line	:	120 MEADOWCREST ST
Second Line	:	SUITE 245
City	:	GRETNA
State	:	LA
Zip	:	70056-5255
Country	:	US
Telephone Number	:	504-391-7690
Fax Number	:	504-391-7625

Provider Business Practice Location Address
First Line	:	120 MEADOWCREST ST
Second Line	:	SUITE 245
City	:	GRETNA
State	:	LA
Zip	:	70056-5255
Country	:	US
Telephone Number	:	504-391-7690
Fax Number	:	504-391-7625

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HARISH C. ANAND
Credential	:	M.D.
Telephone Number	:	504-391-7690

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	09/11/2025

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Directions to “PEDIATRICS KID-MED, LLC ” Practice Location

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