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2932 Stagg Ave Basile LA 70515-5560 | |
(337) 432-5552 | |
(337) 432-5553 |
Full Name | |
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Speciality | Clinic/Center |
Location | 2932 Stagg Ave, Basile, Louisiana |
Authorized Official Name and Position | Kevin F Frank (CEO) |
Authorized Official Contact | 3375807504 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2932 Stagg Ave Basile LA 70515-5560 Ph: (337) 432-5552 | 2932 Stagg Ave Basile LA 70515-5560 Ph: (337) 432-5552 |
NPI Number | 1225689821 |
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Provider Enumeration Date | 09/25/2019 |
Last Update Date | 06/18/2021 |
Medicare PECOS PAC ID | 0840521209 |
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Medicare Enrollment ID | O20200903002941 |
Identifier | Type | State | Issuer |
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1225689821 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |