Provider Demographics
NPI:1801135124
Name:GODBEY-CARE LLC
Entity type:Organization
Organization Name:GODBEY-CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:GODBEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-897-7845
Mailing Address - Street 1:307 AUDUBON BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70125-4124
Mailing Address - Country:US
Mailing Address - Phone:504-861-4123
Mailing Address - Fax:
Practice Address - Street 1:3525 PRYTANIA ST
Practice Address - Street 2:SUITE 430
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3500
Practice Address - Country:US
Practice Address - Phone:504-897-7845
Practice Address - Fax:504-897-7879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15035R261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1166073Medicaid
LA4F699D913Medicare PIN
TXH07892Medicare UPIN