NORTHSHORE PROVIDER GROUP LLC

HAMMOND, LA
NPI1285180158
Entity TypeOrganization
Authorized ContactJAMES I MATHEWS
Owner
337-315-9686
Organization Subpart ?No
Primary Taxonomy363L00000X Nurse Practitioner
Additional Taxonomies314000000X Skilled Nursing Facility
Enumeration Date2016-08-30
Last Update Date2016-08-30
Business Address
NORTHSHORE PROVIDER GROUP LLC
48529 RED FOX DR
HAMMOND, LA 70401-3715
Phone number: 337-315-9686
Mailing Address
NORTHSHORE PROVIDER GROUP LLC
PO BOX 1063
HAMMOND, LA 70404-1063
Phone number: 337-315-9686