| Westbank Renal Associates, Llc | |
|
1111 Medical Center Blvd Suite N 304 Marrero LA 70072-3151 | |
| (504) 349-6808 | |
| (504) 349-6811 |
| Full Name | Westbank Renal Associates, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1111 Medical Center Blvd, Marrero, Louisiana |
| Authorized Official Name and Position | Chakkungal P. Devidoss (OWNER) |
| Authorized Official Contact | 5043496808 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Westbank Renal Associates, Llc 1111 Medical Center Blvd Suite N 304 Marrero LA 70072-3151 Ph: (504) 349-6808 | Westbank Renal Associates, Llc 1111 Medical Center Blvd Suite N 304 Marrero LA 70072-3151 Ph: (504) 349-6808 |
| NPI Number | 1528255189 |
|---|---|
| Provider Enumeration Date | 09/27/2007 |
| Last Update Date | 01/27/2009 |
| Medicare PECOS PAC ID | 4587745534 |
|---|---|
| Medicare Enrollment ID | O20080115000770 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528255189 | NPI | - | NPPES |
| 1347787 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 03747R (Louisiana) | Primary |
| Provider Name | Arnold B Alper |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1477509107 PECOS PAC ID: 4981616802 Enrollment ID: I20060614000297 |
| Provider Name | Chakkungal Devidoss |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1104808302 PECOS PAC ID: 2668561978 Enrollment ID: I20080115000757 |
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