# EAST JEFFERSON GENERAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295014090
- **Authorized official:** JAMES P REVELS (DIRECTOR)
- **Authorized official phone:** (504) 454-4804

## Contact information

- **Practice address:** 4200 HOUMA BLVD, METAIRIE, LA 70006-2970
- **Practice address phone:** (504) 503-4855
- **Practice address fax:** (504) 454-4860
- **Mailing address:** 4200 HOUMA BLVD, METAIRIE, LA 70006-2970
- **Mailing address phone:** (504) 503-4855

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336I0012X | Institutional Pharmacy | PHY.004214-HOSP | LA | Yes |

## Other

- **Enumeration date:** 08/10/2011
- **Last updated:** 12/20/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2029843 | PK | — |