Provider Demographics
NPI:1356854103
Name:JENCARE NEIGHBORHOOD MEDICAL METAIRIE, LLC.
Entity Type:Organization
Organization Name:JENCARE NEIGHBORHOOD MEDICAL METAIRIE, LLC.
Other - Org Name:JENCARE NEIGHBORHOOD MEDICAL CENTER UPTOWN
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR CLIENT SVC
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-628-6117
Mailing Address - Street 1:CHEN MEDICAL CORPORATE OFFICE
Mailing Address - Street 2:1395 N.W. 167TH STREET
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:JENCARE NEIGHBORHOOD MEDICAL CENTER UPTOWN
Practice Address - Street 2:2820 NAPOLEON AVENUE, SUITE 590
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115
Practice Address - Country:US
Practice Address - Phone:305-628-6117
Practice Address - Fax:305-363-5989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-14
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No332900000XSuppliersNon-Pharmacy Dispensing SiteGroup - Multi-Specialty