Organization
C&M MEDICAL SERVICES-ST ELIZABETH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRIS MANDRY M.D. (PRESIDENT)
(504) 833-7770
Entity
Organization
Contact information
Practice address
1125 WEST LOUISIANA HIGHWAY 30, GONZALES, LA 70737
(225) 647-5000
(225) 647-6066
Mailing address
3223 8TH ST, FLOOR 3, METAIRIE, LA 70002-1623
(504) 833-7770
(504) 833-4025
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
017058
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J3181
BC/BS OF LA
LA
Enumeration date
01/12/2011
Last updated
01/09/2012
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