Organization
FAIRWAY MEDICAL CENTER, LLC
Active
Other names
Avala
Organization subpart
No
Provider details
NPI number
Authorized official
LORI FREY (DIRECTOR REVENUE CYCLE)
(985) 801-6258
Entity
Organization
Contact information
Practice address
67252 INDUSTRY LN, COVINGTON, LA 70433-8704
(985) 809-9888
(985) 801-3099
Mailing address
67252 INDUSTRY LN, COVINGTON, LA 70433-8704
(985) 809-9888
(985) 801-3099
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
02/02/2021
Last updated
06/01/2023
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