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Organization
ST. CHARLES VISION OUTLET ELMWOOD, LLC
Active
Organization
ST. CHARLES VISION OUTLET ELMWOOD, LLC
Active
Other names
ST. CHARLES VISION ELMWOOD
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANET DUPLESSIS (INSURANCE ADMINISTRATOR)
(504) 247-9116
Entity
Organization
Contact information
Practice address
837 S CLEARVIEW PKWY, JEFFERSON, LA 70121-3119
(504) 733-0406
(504) 733-0801
Mailing address
837 S CLEARVIEW PKWY, JEFFERSON, LA 70121-3119
(504) 733-0406
(504) 733-0801
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1079242T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410026332
MEDICARE RAILROAD
LA
Enumeration date
12/13/2005
Last updated
06/13/2012
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