Provider Demographics
NPI:1538284104
Name:TEAMCARE MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:TEAMCARE MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF THERAPY
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:KERN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:504-822-8555
Mailing Address - Street 1:2475 CANAL ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6549
Mailing Address - Country:US
Mailing Address - Phone:504-822-8555
Mailing Address - Fax:
Practice Address - Street 1:2475 CANAL ST
Practice Address - Street 2:SUITE 210
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6549
Practice Address - Country:US
Practice Address - Phone:504-822-8555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA470261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation