Organization
ENDOCENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAZEL BRAUEN (BUSINESS MANAGER)
(985) 871-1721
Entity
Organization
Contact information
Practice address
131-A CHEROKEE ROSE LANE, COVINGTON, LA 70433-7195
(985) 809-8068
(985) 809-7172
Mailing address
PO BOX 848816, BOSTON, MA 02284-8816
(985) 809-8068
(985) 893-6908
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
120
LA
261QE0800X
Endoscopy Clinic/Center
Primary
88
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568490
—
LA
01
—
490004975
MEDICARE RAILROAD
LA
Enumeration date
11/17/2006
Last updated
05/15/2023
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