Provider Demographics
NPI:1164005906
Name:CONCERNED CARE PALLIATIVE SERVICES LLC
Entity Type:Organization
Organization Name:CONCERNED CARE PALLIATIVE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGED CARE CONSULTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-914-8284
Mailing Address - Street 1:513 E SCENIC DR
Mailing Address - Street 2:
Mailing Address - City:PASS CHRISTIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39571-4510
Mailing Address - Country:US
Mailing Address - Phone:985-892-3947
Mailing Address - Fax:504-210-1978
Practice Address - Street 1:19550 N 10TH ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-8831
Practice Address - Country:US
Practice Address - Phone:985-892-3947
Practice Address - Fax:504-210-1978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty