Organization
JEFFERSON AMBULATORY SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TANIA TORRES (BUSINESS OFFICE MANAGER)
(504) 832-2115
Entity
Organization
Contact information
Practice address
2701 LAKE VILLA DR, METAIRIE, LA 70002-6714
(504) 274-3100
(504) 274-3199
Mailing address
1207 N CAUSEWAY BLVD, METAIRIE, LA 70001-4129
(504) 832-2115
(504) 832-2116
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
139
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20373
BLUE CROSS OF LA
LA
Enumeration date
08/18/2006
Last updated
08/22/2020
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