Organization
PACE GREATER NEW ORLEANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GORDON R WADGE (PRESIDENT)
(504) 596-3099
Entity
Organization
Contact information
Practice address
4201 N RAMPART ST, NEW ORLEANS, LA 70117-5334
(504) 945-1531
Mailing address
4201 N RAMPART ST, NEW ORLEANS, LA 70117-5334
(504) 945-1531
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1714470
—
LA
Enumeration date
02/23/2007
Last updated
08/16/2007
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