Alexandria Primary Care Clinic | |
224 Pecan Park Ave Rm B1 Alexandria LA 71303-3308 | |
(318) 769-2475 | |
Not Available |
Full Name | Alexandria Primary Care Clinic |
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Speciality | Clinic/Center |
Location | 224 Pecan Park Ave Rm B1, Alexandria, Louisiana |
Authorized Official Name and Position | Melanie Lacour (FAMILY NURSE PRACTITIONER) |
Authorized Official Contact | 3187692475 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Alexandria Primary Care Clinic 6501 Tennyson Oaks Ln Alexandria LA 71301-2765 Ph: (318) 769-2475 | Alexandria Primary Care Clinic 224 Pecan Park Ave Rm B1 Alexandria LA 71303-3308 Ph: (318) 769-2475 |
NPI Number | 1245853803 |
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Provider Enumeration Date | 05/18/2020 |
Last Update Date | 05/18/2020 |
Medicare PECOS PAC ID | 2860812658 |
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Medicare Enrollment ID | O20201016000485 |
Identifier | Type | State | Issuer |
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1245853803 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Melanie A Lacour |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104176130 PECOS PAC ID: 8426284969 Enrollment ID: I20131112000306 |
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