Organization
EAST JEFFERSON GENERAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES P REVELS (DIRECTOR)
(504) 454-4804
Entity
Organization
Contact information
Practice address
4200 HOUMA BLVD, METAIRIE, LA 70006-2970
(504) 503-4855
(504) 454-4860
Mailing address
4200 HOUMA BLVD, METAIRIE, LA 70006-2970
(504) 503-4855
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
PHY.004214-HOSP
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2029843
PK
—
Enumeration date
08/10/2011
Last updated
12/20/2017
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