Provider Demographics
NPI:1528225927
Name:NOTRE DAME HEALTH SYSTEM
Entity Type:Organization
Organization Name:NOTRE DAME HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:R
Authorized Official - Last Name:TULLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-394-5991
Mailing Address - Street 1:2832 BURDETTE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70125-2514
Mailing Address - Country:US
Mailing Address - Phone:504-866-2741
Mailing Address - Fax:504-866-2861
Practice Address - Street 1:2832 BURDETTE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-2514
Practice Address - Country:US
Practice Address - Phone:504-866-2741
Practice Address - Fax:504-866-2861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA353314000000X
LA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4812410001Medicaid