Organization
CHILDREN'S INTERNATIONAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDUARDO HERNANDEZ MD (CEO/MD)
(985) 646-1580
Entity
Organization
Contact information
Practice address
3016 HIGHWAY 80, MORTON, MS 39117-9393
(601) 732-2382
(601) 732-2384
Mailing address
59101 AMBER ST, SLIDELL, LA 70461-3708
(985) 646-1580
(985) 646-1579
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015381
—
MS
Enumeration date
11/02/2016
Last updated
11/02/2016
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