Organization Name: | WEST JEFFERSON CT SCAN LLC |
NPI Number: | 1013918077 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | EDWIN B. ROSS (PRESIDENT) |
Mailing Address: | 4525 Westbank Expy Suite A Marrero |
State: | LA US |
Postal Code: | 700723120 |
Phone Number: | 5043496570 |
Fax Number: | 5043496575 |
NPI Enumeration Date: | 08/02/2005 |
NPI Last Update Date: | 03/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 293D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Laboratories |
Taxonomy Classification: | Physiological Laboratory |
Taxonomy Specialization: | |
Taxonomy Definition: | A laboratory that operates independently of a hospital and physician |