Organization
SOUTHERN REGIONAL MEDICAL CORPORATION
Active
Parent organization
SOUTHERN REGIONAL MEDICAL CORPORATION
Other names
Leonard Chabert Med Ctr Out Pt Phcy
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHERN REGIONAL MEDICAL CORPORATION
Authorized official
PHYLLIS PEOPLES (PRESIDENT AND CEO)
(985) 873-4620
Entity
Organization
Contact information
Practice address
1978 INDUSTRIAL BLVD, HOUMA, LA 70363-7055
(985) 873-1282
Mailing address
8166 MAIN ST, HOUMA, LA 70360-3404
(985) 873-4141
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1233382
—
LA
01
—
1930379
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/13/2013
Last updated
08/13/2013
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