Basic Information
Provider Information
NPI: 1003321597
EntityType: 2
ReplacementNPI:  
OrganizationName: BAPTIST COMMUNITY HEALTH SERVICES, INC.
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Mailing Information
Address1: 4960 SAINT CLAUDE AVE
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701174258
CountryCode: US
TelephoneNumber: 5047045949
FaxNumber:  
Practice Location
Address1: 1616 CAFFIN AVE
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701172950
CountryCode: US
TelephoneNumber: 5045334999
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/06/2017
LastUpdateDate: 03/01/2018
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: BENANDI
AuthorizedOfficialFirstName: TINA
AuthorizedOfficialMiddleName: MARIE
AuthorizedOfficialTitleorPosition: BILLI
AuthorizedOfficialTelephone: 5047045949
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QF0400XLALCS31529LAY Ambulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)

No ID Information.


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