Provider Demographics
NPI:1154464451
Name:HARVEY MEDCARE LLC
Entity Type:Organization
Organization Name:HARVEY MEDCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRAM
Authorized Official - Middle Name:VU
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:
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:2007-02-15
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent MedicineGroup - Multi-Specialty
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1422321Medicaid
LA5CN88Medicare PIN
LA4J108Medicare PIN