Provider Demographics
NPI:1710347372
Name:DOCTORS AFTER HOURS URGENT CARE & WALK IN CLINIC - MANHATTAN LLC
Entity Type:Organization
Organization Name:DOCTORS AFTER HOURS URGENT CARE & WALK IN CLINIC - MANHATTAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SRINIVAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KATA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-952-5677
Mailing Address - Street 1:4525 FOLSE DR
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-1256
Mailing Address - Country:US
Mailing Address - Phone:504-336-2515
Mailing Address - Fax:
Practice Address - Street 1:2515 MANHATTAN BLVD
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-3433
Practice Address - Country:US
Practice Address - Phone:504-336-2515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-25
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAI61601Medicare UPIN