Provider Demographics
NPI:1811154875
Name:TUHC COMMUNITY CARE GROUP
Entity type:Organization
Organization Name:TUHC COMMUNITY CARE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LAGESSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-988-7044
Mailing Address - Street 1:1415 TULANE AVE
Mailing Address - Street 2:ENROLLMENT DEPARTMENT, ROOM 6812
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2600
Mailing Address - Country:US
Mailing Address - Phone:504-988-3290
Mailing Address - Fax:504-988-6216
Practice Address - Street 1:1415 TULANE AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2600
Practice Address - Country:US
Practice Address - Phone:504-988-3290
Practice Address - Fax:504-988-6216
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TUHC PHYSICIAN GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1444910Medicaid