Provider Demographics
NPI:1003247966
Name:HARVEY MEDCARE LLC
Entity Type:Organization
Organization Name:HARVEY MEDCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:QUANG
Authorized Official - Middle Name:T
Authorized Official - Last Name:VU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-348-2310
Mailing Address - Street 1:3709 WESTBANK EXPY
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-2600
Mailing Address - Country:US
Mailing Address - Phone:504-348-2310
Mailing Address - Fax:504-348-1942
Practice Address - Street 1:3709 WESTBANK EXPY
Practice Address - Street 2:SUITE 1B
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-2600
Practice Address - Country:US
Practice Address - Phone:504-348-2310
Practice Address - Fax:504-348-1942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA024975207R00000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAI18683Medicare UPIN
LA4J108Medicare PIN