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Organization
JEFFERSON COMMUNITY HEALTH CARE CENTERS INC
Active
Organization
JEFFERSON COMMUNITY HEALTH CARE CENTERS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS STACEY MARIE LOVELL (BILLING OFFICE/CREDENTIALING)
(504) 436-2223
Entity
Organization
Contact information
Practice address
4028 HIGHWAY 90 W, AVONDALE, LA 70094-2622
(504) 436-2223
(504) 436-2224
Mailing address
4028 HIGHWAY 90 W, AVONDALE, LA 70094-2622
(504) 436-2223
(504) 436-2224
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447196
—
LA
Enumeration date
11/18/2005
Last updated
08/22/2020
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