MEDICARE: VASCULAR ACCESS CENTER OF NEW ORLEANS, LLC

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	2086S0129X	Vascular Surgery Physician
2	2085R0204X	Vascular & Interventional Radiology Physician

General Provider Information

NPI Number	:	1609034396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VASCULAR ACCESS CENTER OF NEW ORLEANS, LLC

Provider Business Mailing Address
First Line	:	285 WILMINGTON W CHESTER PIKE
Second Line	:
City	:	CHADDS FORD
State	:	PA
Zip	:	19317-9039
Country	:	US
Telephone Number	:	610-558-2800
Fax Number	:	610-558-4839

Provider Business Practice Location Address
First Line	:	1 GALLERIA BLVD
Second Line	:	SUITE 110
City	:	METAIRIE
State	:	LA
Zip	:	70001-2082
Country	:	US
Telephone Number	:	504-708-4400
Fax Number	:	504-708-4410

Authorized Official
Title or Position	:	DIRECTOR OF OPERATION
Name	:	MR. RAE CREWS
Credential	:
Telephone Number	:	662-579-3484

Provider Enumeration Date	:	05/29/2008
Last Update Date	:	06/12/2024

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