MEDICARE: EHO2002, 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	314000000X	Skilled Nursing Facility		LA

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	:	1942209531
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EHO2002, LLC

Provider Business Mailing Address
First Line	:	3049 S SHERWOOD FOREST BLVD
Second Line	:	SUITE 200
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-2277
Country	:	US
Telephone Number	:	225-927-4290
Fax Number	:	225-927-5385

Provider Business Practice Location Address
First Line	:	9660 LAKE FOREST BLVD
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70127-2619
Country	:	US
Telephone Number	:	504-244-9013
Fax Number	:	504-241-5330

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	SHERRY MIX
Credential	:
Telephone Number	:	225-927-4290

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	08/22/2020

Similar Medicare Providers

1184357931 — BRICELYN CARTER
Practice Location Address:

9600 LAKE FOREST BLVD
NEW ORLEANS, LA
70127-2619

Practice Phone: 504-327-9804
Practice Fax:

1447435045 — DR. ROSCOE WILKS JR. DMD
Practice Location Address:

2619 JASMINE ST
NEW ORLEANS, LA
70122-6017

Practice Phone: 504-304-0472
Practice Fax:

1760647663 — WILLIAM E FOWLER
Practice Location Address:

309 CRYSTAL ST
NEW ORLEANS, LA
70124-2619

Practice Phone: 985-781-0548
Practice Fax: 985-781-4319

1770231193 — MS. TIEARA DOKES
Practice Location Address:

2619 MUSIC ST
NEW ORLEANS, LA
70117-7913

Practice Phone: 504-616-7121
Practice Fax:

1043210487 — DAVID L SCHMOLLY OD
Practice Location Address:

537 MOUNT JACKSON RD
NEW CASTLE, PA
16102-2619

Practice Phone: 724-667-2020
Practice Fax: 724-667-9201

1366403651 — MS. AMY BETH CONNOR OTR/L
Practice Location Address:

2619 TRENT RD
NEW BERN, NC
28562-2025

Practice Phone: 252-497-5241
Practice Fax:

Directions to “EHO2002, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.