Provider Demographics
NPI:1053352633
Name:MEDICAL CENTER OF LOUISIANA AT NEW ORLEANS
Entity type:Organization
Organization Name:MEDICAL CENTER OF LOUISIANA AT NEW ORLEANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE CHANCELLOR/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:SMITHBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-922-1474
Mailing Address - Street 1:1532 TULANE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2860
Mailing Address - Country:US
Mailing Address - Phone:504-903-3000
Mailing Address - Fax:504-903-3580
Practice Address - Street 1:1532 TULANE AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2860
Practice Address - Country:US
Practice Address - Phone:504-903-3000
Practice Address - Fax:504-903-3580
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICAL CENTER OF LOUISIANA AT NEW ORLEANS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-08
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA60151OtherBCBS REHAB
LA19T005Medicare Oscar/Certification