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Organization
NEW IBERIA SURGERY CENTER LLC
Active
Organization
NEW IBERIA SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK T. MENCACCI RN (ADMINISTRATOR)
(337) 560-9622
Entity
Organization
Contact information
Practice address
2309 E MAIN ST, SUITE 300, NEW IBERIA, LA 70560-4046
(337) 560-1801
Mailing address
2309 E MAIN ST, SUITE 300, NEW IBERIA, LA 70560-4046
(337) 560-1801
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1438545
—
LA
Enumeration date
06/01/2006
Last updated
09/23/2014
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