Azalea Medical Clinic | |
3305 Metairie Rd. Ste. 1 Metairie LA 70001 | |
(504) 434-2330 | |
(504) 885-0820 |
Full Name | Azalea Medical Clinic |
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Speciality | Family Medicine |
Location | 3305 Metairie Rd., Metairie, Louisiana |
Authorized Official Name and Position | Katharine J. Rose (PRESIDENT) |
Authorized Official Contact | 5044342330 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Azalea Medical Clinic 3305 Metairie Rd. Ste. 1 Metairie LA 70001 Ph: (504) 434-2330 | Azalea Medical Clinic 3305 Metairie Rd. Ste. 1 Metairie LA 70001 Ph: (504) 434-2330 |
NPI Number | 1942629589 |
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Provider Enumeration Date | 04/10/2014 |
Last Update Date | 02/28/2019 |
Medicare PECOS PAC ID | 0648533166 |
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Medicare Enrollment ID | O20180416002631 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942629589 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 201310 (Louisiana) | Primary |
251T00000X | Program Of All-inclusive Care For The Elderly (pace) Provider Organization | 201310 (Florida) | Secondary |
Provider Name | Katharine J Rose |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1407985864 PECOS PAC ID: 1557443892 Enrollment ID: I20080125000458 |
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