Provider Demographics
NPI:1932216173
Name:METAIRIE C.T., LLC
Entity Type:Organization
Organization Name:METAIRIE C.T., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:R
Authorized Official - Last Name:ASARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-454-3600
Mailing Address - Street 1:3400 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-4612
Mailing Address - Country:US
Mailing Address - Phone:504-454-3600
Mailing Address - Fax:504-454-3604
Practice Address - Street 1:3400 DIVISION ST
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-4612
Practice Address - Country:US
Practice Address - Phone:504-454-3600
Practice Address - Fax:504-454-3604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5F947Medicare ID - Type UnspecifiedPROVIDER NUMBER