Basic Information
| Provider Information | |||||||||
| NPI: | 1821098286 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | TOURO INFIRMARY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1401 FOUCHER ST | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701153515 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048977011 | ||||||||
| FaxNumber: | 5048978769 | ||||||||
| Practice Location | |||||||||
| Address1: | 1401 FOUCHER ST | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701153515 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048977011 | ||||||||
| FaxNumber: | 5048978769 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2005 | ||||||||
| LastUpdateDate: | 11/17/2010 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | HAGGARD | ||||||||
| AuthorizedOfficialFirstName: | SUZANNE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF FINANCIAL OFFICER VP | ||||||||
| AuthorizedOfficialTelephone: | 5048978568 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 197 | LA | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 1720470 | 05 | LA | MEDICAID | 1705365 | 05 | LA | MEDICAID | 1797316 | 05 | LA | MEDICAID | 1402036 | 05 | LA | MEDICAID | 1762075 | 05 | LA | MEDICAID |