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Organization
OCHSNER MISSISSIPPI, LLC
Active
Organization
OCHSNER MISSISSIPPI, LLC
Active
Parent organization
OCHSNER MISSISSIPPI, LLC
Other names
Ochsner Health Center - West Picayune
Organization subpart
Yes
Provider details
NPI number
Legal business name
OCHSNER MISSISSIPPI, LLC
Authorized official
EDUARDO BENITEZ (DIRECTOR)
(504) 430-0025
Entity
Organization
Contact information
Practice address
906 SIXTH AVE, PICAYUNE, MS 39466-3802
(601) 798-7529
Mailing address
149 DRINKWATER RD, BAY SAINT LOUIS, MS 39520-1658
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09627255
MEDICAID
MS
Enumeration date
10/21/2020
Last updated
10/21/2020
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