Organization
ST. CHARLES VISION OUTLET ELMWOOD, LLC
Active
Other names
ST. CHARLES VISION ELMWOOD
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANET DUPLESSIS (INSURANCE ADMINISTRATOR)
(504) 247-9116
Entity
Organization
Contact information
Practice address
837 S CLEARVIEW PKWY, JEFFERSON, LA 70121-3119
(504) 733-0406
(504) 733-0801
Mailing address
837 S CLEARVIEW PKWY, JEFFERSON, LA 70121-3119
(504) 733-0406
(504) 733-0801
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1079242T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410026332
MEDICARE RAILROAD
LA
Enumeration date
12/13/2005
Last updated
06/13/2012
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