Provider Demographics
NPI:1689977902
Name:UNIVERSITY MEDICAL CENTER MANAGEMENT CORPORATION
Entity Type:Organization
Organization Name:UNIVERSITY MEDICAL CENTER MANAGEMENT CORPORATION
Other - Org Name:UNIVERSITY MEDICAL CENTER NEW ORLEANS-MEDICAL HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:FEIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-702-4434
Mailing Address - Street 1:2000 CANAL STREET
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112
Mailing Address - Country:US
Mailing Address - Phone:504-702-4434
Mailing Address - Fax:504-702-2118
Practice Address - Street 1:2000 CANAL STREET
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112
Practice Address - Country:US
Practice Address - Phone:504-702-4434
Practice Address - Fax:504-702-2118
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICAL CENTER OF LOUISINA AT NEW ORLEANS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-08
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA191-E261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2132385Medicaid
LA2132385Medicaid