Provider Demographics
NPI:1003134156
Name:GULF SOUTH HOSPICE OF NEW ORLEANS
Entity Type:Organization
Organization Name:GULF SOUTH HOSPICE OF NEW ORLEANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:MERRETT
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:504-525-2643
Mailing Address - Street 1:812 HESPER AVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-2042
Mailing Address - Country:US
Mailing Address - Phone:504-525-2643
Mailing Address - Fax:504-525-2645
Practice Address - Street 1:812 HESPER AVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-2042
Practice Address - Country:US
Practice Address - Phone:504-525-2643
Practice Address - Fax:504-525-2645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-13
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA251G00000X
251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based