Full Name | |
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Speciality | Clinic/Center |
Location | 2906 Main Street, Hessmer, Louisiana |
Authorized Official Name and Position | Nell Fehmie Olguin (CLINIC DIRECTOR) |
Authorized Official Contact | 3182530677 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2906 Main Street Hessmer LA 71341 Ph: (318) 619-5470 | 2906 Main Street Hessmer LA 71341 Ph: (318) 315-7093 |
NPI Number | 1538750039 |
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Provider Enumeration Date | 01/28/2021 |
Last Update Date | 11/08/2021 |
Medicare PECOS PAC ID | 8921380528 |
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Medicare Enrollment ID | O20210304001120 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538750039 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |