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Organization
JEFFERSON AMBULATORY SURGERY CENTER LLC
Active
Organization
JEFFERSON AMBULATORY SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TANIA TORRES (BUSINESS OFFICE MANAGER)
(504) 832-2115
Entity
Organization
Contact information
Practice address
2701 LAKE VILLA DR, METAIRIE, LA 70002-6714
(504) 274-3100
(504) 274-3199
Mailing address
1207 N CAUSEWAY BLVD, METAIRIE, LA 70001-4129
(504) 832-2115
(504) 832-2116
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
139
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20373
BLUE CROSS OF LA
LA
Enumeration date
08/18/2006
Last updated
08/22/2020
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