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Parish Management Consultants, LLC PMC 2006 Annual Report
Parish Management Consultants, LLCPMC2006 Annual Report
a letter
fro
m o
ur c
eo
Blending Excellent Management with Quality Anesthesia Services pmc 2006 annual report | 01
a letter from our ceo
Dear Customers, Board Members, physicians and stakeholders, it is
with great pride that PMC shares this year’s annual report with you.
This report provides you an overview of our 2006 financial and
operational achievements. Our company’s primary goal today remains
the same since our inception, the provision of quality management
services. In this past year, our company has clearly demonstrated the
ability to assist our client Groups and Facilities in attaining mutual
success. This accomplishment was attested to this year by our clients’
decisions to renew all 2006 contracts which were due to term.
Fundamental to PMC’s retention and growth remains our dedication to
sustaining and nurturing our customers’ trust. We believe that this
trust is grounded in the manner in which PMC distinguishes itself in
the market from other practice management companies. The
foundation on which this differentiation is based is critical, making
each one of the following principles important.
It is our belief that first and foremost, the clinical dollars generated by
each of our Groups should remain with that group. In other words, the
financial integrity of each Group is honored and protected. Second,
PMC continually strives to provide value above and beyond our
customers’ expectations at a market competitive rate. It is our job to
provide the very best practice services; it is our vision to assist you in
meeting future challenges. Finally, all of our contractual and financial
relationships with our customers are transparent. We demonstrate
our honesty through our openness.
In closing, I would like to thank our customers for the opportunity to
serve them. We understand clearly that without the support of our
Groups and Facilities we could not succeed. Together, we can deliver
added value to our most important mutual customers, our patients.
Sincerely,
T. Steven Martin
Parish Management Consultants (PMC) is a healthcare management company
dedicated to the provision of world class services. The PMC team, comprised of
anesthesiologists, nurse anesthetists, and healthcare managers, is driven to provide
the best quality anesthesia as defined by national benchmarks, supported by results
oriented and quantifiable management services. PMC will aggressively pursue
growth, retention, and differentiation strategies that will result in PMC becoming the
number one anesthesia company in the United States. In addition to providing
anesthesia services, PMC will investigate and implement other healthcare
management strategies that bring value to the company.
pmc mission statement
pmc values
Parish Management Consultants, LLCPMC
PMC differentiates itself from its competitors through development of its employees
and services
Guarantees performance
Will be aggressive in implementing technology that results in dramatically improved
quality service, increased efficiencies, and rapid return on investment
Will strive to achieve 100% compliance in all aspects of management and healthcare
delivery
Will be open to risk sharing arrangements
Will communicate with its employees and partners with candor and open
communication
Will relentlessly pursue true win/win relationships
Will work to deliver to its customer's value above and beyond contractual
obligations
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pmc
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pmc overview
Louisiana
Virginia
Baton Rouge General Medical Center
East Jefferson General Hospital
East Jefferson Ambulatory Surgery Center
Fairway Medical Center
Greater New Orleans Surgery Center
Houma Outpatient SurgeryPlex
Lakeview Regional Medical Center
Lafayette General Medical Center
Ochsner Medical Center - Westbank
Omega Hospital
St. Francis Medical Center
Touro Infirmary
West Jefferson Medical Center
West Jefferson Ambulatory Surgery Center
Inova Alexandria Hospital
the facilities we serve
pmc
over
view
& the
fac
ilitie
s we
serv
e
Blending Excellent Management with Quality Anesthesia Services pmc 2006 annual report | 03
MonroeMonroeAlexandriaAlexandria
LafayetteLafayette
Baton RougeBaton Rouge
CovingtonCovington
MetairieMetairie
MarreroMarrero GretnaGretna
VIRGINIAVIRGINIA
LOUISIANALOUISIANA
Parish Management Consultants is a practice management company created by
anesthesiologists to assist them in addressing new market challenges in anesthesia.
Over the past several years, the Parish Groups found themselves facing serious
manpower shortages, complex facility negotiations and contracts, declining pay from
their third-party payors, and more regulatory requirements than ever. In order to
address these challenges the Parish leadership recognized the need to recruit
professional managers with expertise in healthcare management, including contract
negotiations, recruitment, human resources, and finance. The physicians wanted to
create a management team that could interface and relate with the management
team of their respective facilities. The physician leaders believed that their success
today and into the future would rely heavily on their Groups ability to integrate their
businesses with the operations of their facilities. In summary, PMC was designed to
achieve that objective. PMC’s success has resulted in it becoming the eleventh (11)
largest anesthesia provider in the United States. In addition, PMC is an active
founding member in the Anesthesia Business Group (ABG) which is a consortium of
nine (9) of the largest privately owned groups in the country.
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pmc year in review
pmc
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2006 Year in Review
Anesthesia Department Leadership
Chief CRNAs
We would like to thank the medical staff and administration of each PMC partner
facility for their confidence in our doctors, our nurses and our staff. Your faith in our
ability to provide the highest quality patient care and anesthesia service encourages
us to continue to strive to be the best at what we do. We worked diligently throughout
2006 to provide services and introduce new programs and processes to increase and
enhance our value to you. Your patients are our patients, your success our success
and we wish all of our valued partners much success in 2007.
It’s no surprise that a world class organization would have world class medical
directors. Parish medical directors are clinicians as well as managers of their
respective anesthesia departments. They participate in regular clinical rotations and
assist in providing medical direction to our CRNAs. In addition, they all share in call
rotations. When they are not in the operating room or on call, our medical directors
attend M&M conferences, quality assurance and compliance reviews, and monthly
divisional meetings. They also chair and participate in their own Perioperative
Operations Committee (POC) meetings and work with PMC group practice managers
on quality initiatives, contract performance and human resource issues. Our medical
directors also attend PMC leadership conferences and participate in their facility’s
medical staff committees and development programs.
The March 30, 2007 PMC Leadership Conference kicks off this year’s management
development efforts, featuring speakers and programs on:
Leadership
Quality Initiatives
Electronic Anesthesia Record Systems
Compliance
Pay for Performance, and
Human Resource topics
PMC recognizes that our medical directors are key to the success of our
efforts and we thank each of them for their continuing commitment to outstanding
patient care.
PMC believes that the “team model” approach to patient care is the centerpiece of the
very best patient care. To this end PMC embraces the medically directed model, which
means that each of our CRNAs play an essential role in the delivery of anesthesia care.
PMC requires that each anesthesia department select a Chief CRNA, who plays a very
important role in assisting the medical director in the management and development
of the anesthesia department, and facilitates communication with the CRNA staff. This
year as in years past Chief CRNAs and Co-Chief CRNAs will participate in the PMC
Leadership Conferences. Congratulations and thank you for your commitment to
leadership and patient care.
Blending Excellent Management with Quality Anesthesia Services pmc 2006 annual report | 05
Human Resources & Recruitment
PMC would like to welcome the doctors, nurses, managers and staff members who
began their employment with us in 2006. In total we recruited 28 healthcare
providers and 9 management professional staff members. Carolyn Wooton, Vice
President of Human Resources, and her staff have done a phenomenal job of
recruitment this past year. As noted in a recent Times-Picayune article, almost 60%
of the New Orleans area physicians, nurses and other healthcare professionals left
the city after Hurricane Katrina and the current environment has created a unique
set of challenges that makes this past year’s recruitment success that much more
remarkable.
While size and growth in employees is not a criterion for success, it speaks to
our ability to meet the coverage needs of our facility partners. PMC doctors and
nurses comprise over 88 percent of our employees, which is what matters to our
customers. This brings our total provider network to over 205 anesthesia providers.
More doctors and nurses allow us to provide more patient care.
PMC has been very successful in building relationships with schools
throughout the country. In 2006 we had two recruitment dinners, an information
session for the LSU Student CRNA Juniors and Seniors and we expanded our
clinical rotation commitments to all of our current participating sites. PMC is
working closely with LSU, Texas Christian University, Texas Wesleyan University,
Georgetown University, Virginia Commonwealth University and University of
Alabama in Birmingham to continue to expand the clinical sites throughout the
Parish network. This, we believe, is essential to a successful ongoing CRNA
recruitment program.
Finally, with the assistance of our Medical Directors and Chief CRNAs PMC
developed a comprehensive orientation program for both doctors and nurses that
includes education on company policies and procedures, quality initiatives and
compliance. Our goal is to help all of our Medical Directors and Chief CRNAs be
successful by making them excellent managers and effective change agents of our
leadership team.
pmc year in review
pmc
year
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2004 2005 2006
Tota
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of E
mpl
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Parish AnesthesiaEmployee Growth
188188
201
175
220
200
225
2006 Goal Achievements
National Strategic Business Partners
Finance
Throughout 2006 PMC met and exceeded an array of goals we had set for ourselves,
our partners and our customers. With concerted team efforts, new services were
implemented and existing services were enhanced and improved.
Strategic business partners help ensure every great company’s success, and bring
added value to our customers. The key is of course the right selection, character and
teamwork of those partners. In short, pick the best and continue to challenge them to
improve. This is the philosophy at PMC and it is what keeps us among the top
companies in our industry. PMC and Anesthesia Business Consultants (ABC) continued
its partnership last year with new and enhanced services. In 2006 PMC welcomed
Chase Bank to our select team of primary partners. Working with each of these
companies provides PMC and our customers with unparalleled services and support.
In 2006, PMC and ABC improved and implemented new monthly billing and
collection management reports for all Parish sites. We look forward to working with
the very capable management and staff of this exceptional, national organization.
It was also this past year that PMC and J.P. Morgan Chase Bank implemented a
new banking relationship and lock box system for processing collections. Lock boxes
maximize the security of collections and provide an invaluable audit trail. As PMC
moves forward in 2007, our banking partner will continue to provide a whole host of
valuable financial services to the organization, our doctors and nurses and the
facilities we serve.
In addition to the partnering strengths PMC made in 2006, PMC has been an
important contributor in the planning and development of the Anesthesia Business
Group (ABG) National Quality Initiative. Significant progress has also been made in
the planning and development of a company wide Parish Quality Initiative. Currently,
East Jefferson General Hospital is serving as the Beta site for the Parish program,
which will then be expanded to other Parish sites in 2007.
Bridget Galatas, Chief Financial Officer, and her staff continue to provide excellent
accounting and financial services for PMC. Accurate budgeting, constant monitoring
and reporting, managed care contracting and strategic financial decision making are
critical elements of our services that benefit our customers.
Guaranteed billing and collection performance is also a hallmark of our value. In
2006 there was remarkable growth in charges overall as well as the number of cases
and units of anesthesia. The goal, of course, is not to generate charges, but to deliver
the necessary care while being faithful to accurately documenting the services
provided so that the correct reimbursement is received. And, while patient care is
first, foremost and the highest priority, PMC management is mindful that we must be
financially responsible in both revenue generation and expense management.
During the past year PMC successfully completed billing company conversions
at our facilities in both Lafayette, Louisiana and Alexandria, Virginia.
2006 growth & achievements
0
$40M
2004 2005 2006
$50M
Case Volume
77,41966,54763,896
0
90,000
2004 2005 2006
30,000
Total Revenues
48.749.7 50.0
60,000
06
2006 g
rowth
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Blending Excellent Management with Quality Anesthesia Services pmc 2006 annual report | 07
2006 g
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Finalized a PMC contract to manage Anesthesia Associates in Alexandria,
Virginia. This group is comprised of approximately 28 anesthesia providers.
This contract gives PMC a multi-state presence and provides a base for
future development. Our success in Virginia has allowed us to open a full-
service regional office.
Negotiated a management consultant agreement with Touro Infirmary,
which will lead to a management services agreement in 2007.
Negotiated a management consultant agreement with Loudoun Anesthesia
Associates in Virginia.
Negotiated a management consultant agreement with Manassas Anesthesia
Associates in Virginia.
2006 growth & achievements
Business Operations
New Clients
Robert Wright, Chief Operating Officer, has assembled a top notch team of
professionals to respond to the needs of our customers. Areas of operational
excellence include but are not limited to practice management, quality initiatives,
compliance, financial and billing operations, perioperative assessments and human
resource support such as recruitment, credentialing, training and development and
performance evaluations.
Kathy Pratt, Vice President of Clinical Services, has been the most recent
addition to the PMC senior management team. With over 20 years of perioperative
operations management experience, she has been able to develop our quality
initiatives, compliance and clinical operation assessments to a new level. Kathy has
also been instrumental in starting up PMC’s practice management services in the
state of Virginia.
Other PMC major achievements in 2006 included a comprehensive 2006
Disaster Plan. This plan was developed and created with its goal for PMC to be fully
operational within 24 hours of a major hurricane landfall or other catastrophe.
Electronic credentialing software was implemented to create improved
efficiencies and accuracy. This software system has reduced the turnaround time for
completing the credentialing application process by 75%.
PMC developed and setup a managed care strategy to negotiate contracted
rates to the highest level possible based on market conditions and our cost structure.
A successful Leadership Conference for Parish Medical Directors and Chief
CRNAs was planned and hosted by PMC. Compliance, quality and strategic planning
were highlighted at the conference.
PMC successfully renegotiated a five year contract with Baton Rouge General
Medical Center and a new contract with Fairway Medical Center.
Lastly, PMC implemented an improved orientation program for Parish Medical
Directors and Chief CRNAs.
pmc executive team
Seated from left: T. Steven Martin,
Standing from left:
Kathy Pratt, Carolyn Wooton
Robert Wright, Bridget Galatas
T. Steven Martin
President and CEO
Steve is a co-founder of Parish Management Consultants and its
President and CEO. Steve has been in healthcare for more than
30 years and during that time has worked in hospital
administration, managed care, physician practice management,
and clinical care. He has a masters degree in Healthcare
Administration from the University of Alabama Birmingham.
As president and CEO, Steve provides leadership and
direction to the organization. His entrepreneurial spirit has been
the driving force behind the remarkable growth and success of
Parish Management Consultants.
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pmc
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Robert Wright
Chief Operating Officer
Bridget Galatas
Chief Financial Officer
Robert joined Parish Management Consultants in May 2004. His
career in healthcare administration spans more than 20 years in
executive positions at both not-for-profit and for-profit hospital
systems. His extensive experience includes Administrator of
Operations at Mercy Hospital of New Orleans, and Chief Operating
Officer of Tenet Memorial Medical Center in New Orleans.
As Chief Operating Officer, Robert is responsible for
oversight of company operations and implementation of policies
and procedures, as well as monitoring the achievement of the
organization’s goals and objectives.
Bridget has been with Parish Management Consultants since its
inception in 2003. She has been working in the medical field since
1995 and has been involved in all aspects of healthcare financial
management. Bridget came to Parish Management Consultants
from the renowned Ochsner Clinic Foundation of New Orleans.
Bridget has a masters degree in Healthcare Administration from
the University of New Orleans.
As Chief Financial Officer, Bridget oversees all aspects of
PMC’s accounting and financial functions, as well as oversight of
each divisions operating budget and financial reporting. As a
financial analyst, Bridget works closely with our partnering
facilities operations and financial officers. Bridget’s staff and audit
team members monitor and manage PMC partner relationships
with our billing and collections companies.
Blending Excellent Management with Quality Anesthesia Services pmc 2006 annual report | 09
pmc
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pmc executive team
Kathy Bandhu, CRNA
Kathy Pratt, RN, BSN, MBA, CNOR
Vice President of Clinical Services
Carolyn Wooton
Vice President of Human Resources/Recruiting
Kathy is the Chief CRNA for the East Jefferson General Hospital Division and a clinical
advisor to the Parish Management consulting team. Kathy has been a CRNA for more than
20 years, and while Kathy is very involved in supporting the PMC management team, she
still spends most of her time in the operating room with patients and her surgical team
members. Kathy completed her CRNA training at Geisinger Medical Center in Danville,
Pennsylvania.
As Vice President of CRNA Management and Development, Kathy assists in the
establishment and implementation of quality initiatives in the operating room and works
with the chief CRNAs assigned throughout the company.
As Vice President Clinical Services, Kathy will provide advice and assistance to Parish
Anesthesia Associates and Parish Management Consultants client hospitals and facilities
with quality assurance, anesthesia and surgery department management and serve as the
corporations Medical Compliance Officer. In addition to her clinical operations and
management responsibilities Kathy will oversee the introduction and implementation of
Parish Management Consultant's electronic anesthesia record (EAR) program.
Most recently Kathy was the Surgery Department Director for the Ochsner Clinic
Foundation of New Orleans where she was responsible for daily operations of the Ochsner
Clinic Surgery Program as well as budget development, financial analysis and resource
management.
Kathy is a member of the American College of Healthcare Executives, the New
Orleans Area Organization of Nurse Executives and the Association of Perioperative
Nursing. She has been in healthcare management for over 20 years.
Carolyn has more than 20 years experience in directing human resource functions in the
hospitality industry. Most recently, she was the corporate director of Human Resources
for Expotel Hospitality Services where she was responsible for fourteen hotels. Hotel
brands included Hilton, Hampton and Embassy. These hotels employed more than 1,200
employees around the United States. Her experience in this industry brings a customer-
focused perspective to PMC and our customers. Carolyn has a bachelor of science from
Louisiana State University in Baton Rouge, Louisiana.
As Vice President of Human Resources/Recruiting, Carolyn is responsible for
oversight of these departments, which focus on recruitment and retention of our
employees, as well as development and implementation of policies and procedures. She
also works on the refinement and maintenance of compensation packages for our
provider network and monitors adherence to federal and state employment regulations,
while overseeing training and continuing education programs for all Parish employees.
Neal G. Comarda, M.D.
Mark Henson, M.D.
T. Steven Martin - PMC President and CEO
Dr. Comarda is a co-founder, a member of the Board of Directors and a clinical
advisor to PMC. He is the Medical Director of West Jefferson Medical Center in
Marrero and a practicing clinician. Dr. Comarda has been in practice since 1985, and
in 1987 he co-founded Parish Anesthesia Associates, the parent company of PMC.
A native of New Orleans, Dr. Comarda attended Louisiana State University
School of Medicine in New Orleans and subsequently completed his Anesthesiology
residency at Tulane University Medical Center in New Orleans. He is a Diplomate of
the American Board of Anesthesiology.
Dr. Henson is a co-founder, a member of the Board of Directors and a clinical advisor
to PMC. Dr. Henson is Co-Medical Director of the anesthesia department at East
Jefferson General Hospital and a practicing clinician. In addition to his
responsibilities at East Jefferson General Hospital, Dr. Henson works with Parish
Management Consultants' Medical Directors and Chief CRNAs on operational and
organizational issues affecting the individual facilities and is a clinical mentor to the
organizations executive team.
A graduate of the Medical College of Virginia in Richmond, Virginia, Dr. Henson
completed his residency in Internal Medicine in 1983 and his residency in
Anesthesiology in 1986 at the Ochsner Clinic in New Orleans and is board certified in
both Internal Medical and Anesthesiology.
Please see page 8 for Mr. Martin’s bio.
pmc board of directors
Frank Rosinia, M.D.
Dr. Rosinia is a co-founder, a member of the Board of Directors and
a clinical advisor to Parish Management Consultants. In his role as
clinical advisor, Dr. Rosinia works directly with the Parish
Management Consultants Medical Directors on issues related to
leadership and anesthesia department management was well as
quality outcomes and operational efficiency. In addition to his
responsibilities with PMC, Dr. Rosinia is Co-Medical Director of the
anesthesia department at East Jefferson General Hospital and a
practicing clinician.
Dr. Rosinia is a graduate of Louisiana State University School
of Medicine in New Orleans, completed his residency in
anesthesiology at Ochsner Clinic in New Orleans, and completed
his fellowship training in obstetric anesthesiology and regional
anesthesia at Brigham and Woman’s Hospital, Harvard Medical
School, in Boston.
Standing from left: Frank Rosinia, M.D., Neal G. Comarda, M.D.
and Mark Henson, M.D. Seated: T. Steven Martin
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pmc
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2007 strategic goals
Top Strategic Goals for 2007
Quality - PMC has invested a significant amount of time and money in planning
and developing a computerized Parish Quality Initiative that will be implemented
throughout the Parish system in 2007. Five major company quality performance
goals have been approved by the PMC Board of Directors to be benchmarked
against national standards. These quality indicators relate to anesthesia response
times, reducing surgical patient risk, operating room efficiency, controlling patient
temperature, and reducing surgical infection rates. In addition, the Quality
Initiative prepares PMC to meet the federal Pay for Performance standards that are
being finalized.
Electronic Anesthesia Record Initiative - PMC plans to implement an
electronic anesthesia record initiative within the Parish system. This will provide
cutting edge technology to enhance pre-admission testing, anesthesia care in the
surgical suite and in the post anesthesia care unit (PACU). The electronic
anesthesia record system will assist in achieving 100% compliance in
documentation of anesthesia care and increase net collections due to the accurate
documentation. The information collected by the electronic anesthesia record will
provide a more efficient system to measure quality care performance based on
benchmarked standards.
Growth - Growth is a critical success factor for any organization. PMC has
doubled in size over the past three years and continued growth is projected for
2007. Although PMC is always on the look-out for new opportunities, its current
partner facilities are guaranteed the same quality service that exceeds their
expectations, and PMC is dedicated to increasing its value to its customers each
and every year.
New Ventures - Many PMC clients have requested us to consider managing their
Hospitalist program. Because of this expressed need from various hospitals, PMC is
investigating the resources, reporting, and operational needs required for entry into
this new service line. Many of management resources for this new venture are
already in place, and the relationship building model of service integration mirrors
many of the processes and systems that PMC employs in its anesthesia group
practices. We look forward to offering this new service in 2007.
Blending Excellent Management with Quality Anesthesia Services pmc 2006 annual report | 11
in closing
The Future
While the future is bright, the challenges are immense. The doctors, nurses,
managers and staff of PMC are committed to the goals of the company, the facilities
we serve and most importantly our patients whose care is at the heart of everything
we do. The initiatives outlined for 2007 and beyond will not only advance the delivery
of anesthesia services at our partnering facilities, but will most certainly add value
to the entire healthcare industry.
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in c
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Parish Medical Directorsand Chief CRNAs
East Jefferson General HospitalDr. Frank Rosinia, Co-Medical DirectorDr. Mark Henson, Co-Medical DirectorKathy Bandhu, Chief CRNA
West Jefferson Medical CenterDr. Neal Comarda, Medical DirectorTadd May, Co-Chief CRNATom Smithers, Co-Chief CRNA
Ochsner Medical Center - WestbankDr. Louis Levin, Medical DirectorJohn Spera, Chief CRNA
Lakeview Regional Medical CenterDr. Kenneth Levine, Medical DirectorRandy Provensal, Co-Chief CRNAFred Green, Co-Chief CRNA
Baton Rouge General Medical CenterDr. Son Dang, Medical DirectorKyle Schnebelen, Chief CRNA Jeremy Jones, Assistant Chief CRNA
St. Francis Medical CenterDr. R. Gary Madden, Medical DirectorCarolyn Gates, Chief CRNA
Lafayette General Medical CenterDr. Todd Ackal, Medical DirectorSusan Landry, Chief CRNA
Fairway Medical CenterDr. William Preau, Medical Director
Touro InfirmaryDr. Scott Shows, Medical DirectorDr. Rodrek Williams, Asst. Medical DirectorDenise Gernhauser, Chief CRNA
Inova Alexandria HospitalDr. Reed Underwood, Medical DirectorSuzanne DeVine, Chief CRNA
3510 N. Causeway Blvd. Suite 404, Metairie, LA 70002
Tel: 504-779-5515
Toll Free: 1-866-528-9679
www.anesthesiapmc.com
Parish Management Consultants, LLCPMC
