MEDICARE: NAVAL AMBULATORY CARE CENTER

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	:	1538123435
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NAVAL AMBULATORY CARE CENTER

Provider Business Mailing Address
First Line	:	2300 GENERAL MEYER AVE.
Second Line	:	BLDG H100
City	:	NEW ORLEANS
State	:	LA
Zip	:	70142-0001
Country	:	US
Telephone Number	:	504-678-2400
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 GENERAL MEYER AVE.
Second Line	:	BLDG H100
City	:	NEW ORLEANS
State	:	LA
Zip	:	70142-0001
Country	:	US
Telephone Number	:	504-678-2400
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR, RESOURCE MANAGEMENT
Name	:	MR. JAMES L. AYERS
Credential	:
Telephone Number	:	850-505-6309

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	08/28/2008

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