Provider Demographics
NPI:1134353642
Name:SOUTHERN SURGICAL ASSIST, LLC
Entity type:Organization
Organization Name:SOUTHERN SURGICAL ASSIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RNFA
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:HINTZ
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:504-460-9945
Mailing Address - Street 1:1113 LINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-2309
Mailing Address - Country:US
Mailing Address - Phone:504-460-9945
Mailing Address - Fax:504-264-7434
Practice Address - Street 1:1113 LINWOOD AVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70003-2309
Practice Address - Country:US
Practice Address - Phone:504-460-9945
Practice Address - Fax:504-264-7434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA112468163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty