MEDICARE: HSWL NEWORLEANS

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
1	261QM1100X	Military/U.S. Coast Guard Outpatient Clinic/Center

General Provider Information

NPI Number	:	1396046462
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HSWL NEWORLEANS

Provider Business Mailing Address
First Line	:	1790 SATURN ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70129-2270
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1790 SATURN ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70129-2270
Country	:	US
Telephone Number	:	504-253-4671
Fax Number	:

Authorized Official
Title or Position	:	HS3
Name	:	BRITTANY AMBER VANN
Credential	:
Telephone Number	:	504-253-4671

Provider Enumeration Date	:	11/05/2010
Last Update Date	:	11/05/2010

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Directions to “HSWL NEWORLEANS ” Practice Location

Language	Start Address	Practice Location

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