| Immunization Services Of Louisiana, Llc | |
|
1608 Division St Metairie LA 70001-2712 | |
| (504) 430-3397 | |
| (504) 828-7640 |
| Full Name | Immunization Services Of Louisiana, Llc |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 1608 Division St, Metairie, Louisiana |
| Authorized Official Name and Position | Gregory Gerard Hedrick (OWNER) |
| Authorized Official Contact | 5044303397 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Immunization Services Of Louisiana, Llc 1608 Division St Metairie LA 70001-2712 Ph: (504) 430-3397 | Immunization Services Of Louisiana, Llc 1608 Division St Metairie LA 70001-2712 Ph: (504) 430-3397 |
| NPI Number | 1407120785 |
|---|---|
| Provider Enumeration Date | 03/03/2012 |
| Last Update Date | 03/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407120785 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 17258 (Louisiana) | Primary |
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