Organization
SHENANDOAH MEDICAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY FERRARA (LLC MEMBER)
(225) 752-4530
Entity
Organization
Contact information
Practice address
13828 COURSEY BLVD, BATON ROUGE, LA 70817-1307
(225) 752-4530
(225) 752-4652
Mailing address
13828 COURSEY BLVD, BATON ROUGE, LA 70817-1307
(225) 752-4530
(225) 752-4652
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
015137
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1931802
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/21/2006
Last updated
02/26/2014
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