| Clinics Of The Southeast Llc | |
|
219 S Border Dr Bogalusa LA 70427-3671 | |
| (985) 732-1568 | |
| Not Available |
| Full Name | Clinics Of The Southeast Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 219 S Border Dr, Bogalusa, Louisiana |
| Authorized Official Name and Position | Anthony Jude Palazzo (CEO) |
| Authorized Official Contact | 9857357707 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinics Of The Southeast Llc Po Box 370 Bogalusa LA 70429-0370 Ph: (985) 732-1568 | Clinics Of The Southeast Llc 219 S Border Dr Bogalusa LA 70427-3671 Ph: (985) 732-1568 |
| NPI Number | 1053082743 |
|---|---|
| Provider Enumeration Date | 09/23/2021 |
| Last Update Date | 09/23/2021 |
| Medicare PECOS PAC ID | 6709116239 |
|---|---|
| Medicare Enrollment ID | O20211006002625 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053082743 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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