Provider Demographics
NPI:1417389313
Name:COVINGTON CARDIOVASCULAR CARE AT ST. TAMMANY PARISH HOSPITAL
Entity Type:Organization
Organization Name:COVINGTON CARDIOVASCULAR CARE AT ST. TAMMANY PARISH HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-898-4410
Mailing Address - Street 1:1202 S TYLER ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-2330
Mailing Address - Country:US
Mailing Address - Phone:985-898-4000
Mailing Address - Fax:985-898-4491
Practice Address - Street 1:1006 S HARRISON ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-3661
Practice Address - Country:US
Practice Address - Phone:985-871-4140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. TAMMANY PARISH HOSPITAL DISTRICT #1
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-01
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty