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SLIDELL, LA
NPI1902517659
Entity TypeOrganization
Authorized ContactSHERRIE S MCEWEN
Billing Agent/Credentialing
985-250-8300
Organization Subpart ?No
Primary Taxonomy332H00000X Eyewear Supplier
Enumeration Date2022-12-13
Last Update Date2022-12-13
Business Address
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2050 GAUSE BLVD E STE 150
SLIDELL, LA 70461-5414
Phone number: 985-649-0206
Mailing Address
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2050 GAUSE BLVD E STE 150
SLIDELL, LA 70461-5414
Phone number: 985-649-0206
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