NPI 1790876019 DESTREHAN MEDICAL CLINIC DESTREHAN LA. Find Phone Number, Address, Contact details of medical healthcare providers | NPI Number Lookup

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Destrehan Medical Clinic - NPI: 1790876019

National Provider Identifier (NPI) is a 10-digit identification number which is issued to health care providers by the Centers for Medicare and Medicaid Services (CMS) in the United States(US). The NPI is introduced to replace of UPIN (unique provider identification number) and now NPI is the only required identifier for Medicare services, and NPI is also used by commercial healthcare insurers and by other payers.

Organization Name: DESTREHAN MEDICAL CLINIC
NPI Number: 1790876019
Entity Type Code: Organizational (2)
Authorized Official Name: CHEMMALE JAYAKRISHNAN
(PRESIDENT/DOCTOR)
Mailing Address: 12604 River Rd
Destrehan
State: LA US
Postal Code: 700475306
Phone Number: 9857640439
Fax Number: 9857251464
NPI Enumeration Date: 09/28/2006
NPI Last Update Date: 04/20/2008
Replacement NPI: 0
NPI Deactivation Date:
NPI Reactivation Date:

Taxonomy Information:

Healthcare Provider Taxonomy: 261QP2300X
License Number: =========
Healthcare Provider Taxonomy:
(Secondary)
Y
State: LA
Taxonomy Type: Ambulatory Health Care Facilities
Taxonomy Classification: Clinic/Center
Taxonomy Specialization: Primary Care
Taxonomy Definition:


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