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NPI Code Detail

MEDICARE: BEULAH MOORE

MEDICARE: BEULAH MOORE
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
1171M00000XCase Manager/Care Coordinator5340LA
2104100000XSocial Worker5340LA

General Provider Information

NPI Number : 1841613841
Entity Type Code : Individual
Provider Name (Legal Business Name) : BEULAH MOORE
Provider Business Mailing Address
First Line : 5622 E FOREST ISLE CT APT 83
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70131-8909
Country : US
Telephone Number : 504-214-2940
Fax Number :
Provider Business Practice Location Address
First Line : 2439 MANHATTAN BLVD
Second Line :
City : HARVEY
State : LA
Zip : 70058
Country : US
Telephone Number : 504-333-6657
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2014
Last Update Date : 05/22/2018

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Directions to “ BEULAH MOORE ” Practice Location

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