| Southstar Urgent Care | |
|
6011 Ambassador Caffery Pkwy Youngsville LA 70592-5170 | |
| (337) 234-9925 | |
| (337) 235-3357 |
| Full Name | Southstar Urgent Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 6011 Ambassador Caffery Pkwy, Youngsville, Louisiana |
| Authorized Official Name and Position | Kelly Prejean (PROVIDER ENROLLMENT SPECIALIST) |
| Authorized Official Contact | 3372020720 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southstar Urgent Care 6011 Ambassador Caffery Pkwy Youngsville LA 70592-5170 Ph: (337) 234-9925 | Southstar Urgent Care 6011 Ambassador Caffery Pkwy Youngsville LA 70592-5170 Ph: (337) 234-9925 |
| NPI Number | 1639234495 |
|---|---|
| Provider Enumeration Date | 12/22/2006 |
| Last Update Date | 11/12/2020 |
| Medicare PECOS PAC ID | 1456390798 |
|---|---|
| Medicare Enrollment ID | O20050427000289 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639234495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Primary |
| Provider Name | Winston P Riehl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043375819 PECOS PAC ID: 8628035698 Enrollment ID: I20041213000200 |
| Provider Name | Frank J Garber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215131966 PECOS PAC ID: 1355438102 Enrollment ID: I20071026000249 |
| Provider Name | Francisco J Silva |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952427783 PECOS PAC ID: 9234315060 Enrollment ID: I20110512000391 |
| Provider Name | Alise H Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053744516 PECOS PAC ID: 8325274103 Enrollment ID: I20131127000520 |
| Provider Name | Lorraine Saville |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497196398 PECOS PAC ID: 1557664786 Enrollment ID: I20160122000323 |
| Provider Name | Shawntel Marie Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053652644 PECOS PAC ID: 0648577718 Enrollment ID: I20160502000673 |
| Provider Name | Erin Elizabeth Perek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134818099 PECOS PAC ID: 3173980901 Enrollment ID: I20230608002861 |
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