Organization
CARDIOVASCULAR INSTITUTE OF THE SOUTH, APMC
Active
Parent organization
CARDIOVASCULAR INSTITUTE OF THE SOUTH, APMC
Other names
FAMILY DOCTORS CLINIC OF MATHEWS
Organization subpart
Yes
Provider details
NPI number
Legal business name
CARDIOVASCULAR INSTITUTE OF THE SOUTH, APMC
Authorized official
MR. DAVID C KONUR (CHIEF EXECUTIVE OFFICER)
(985) 876-0300
Entity
Organization
Contact information
Practice address
111 ACADIA PARK DR, RACELAND, LA 70394-2619
(985) 537-7575
(985) 537-7584
Mailing address
225 DUNN ST, HOUMA, LA 70360-4413
(985) 873-5669
(985) 872-0317
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447943
—
LA
Enumeration date
11/19/2007
Last updated
11/19/2007
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