Ellender Family Medicine, Apmc | |
2967 S Union St Opelousas LA 70570-5740 | |
(337) 594-8958 | |
(337) 594-8987 |
Full Name | Ellender Family Medicine, Apmc |
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Speciality | Family Medicine |
Location | 2967 S Union St, Opelousas, Louisiana |
Authorized Official Name and Position | Lee Darrell Ellender (PRESIDENT) |
Authorized Official Contact | 3375948958 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ellender Family Medicine, Apmc 2967 S Union St Opelousas LA 70570-5740 Ph: (337) 594-8958 | Ellender Family Medicine, Apmc 2967 S Union St Opelousas LA 70570-5740 Ph: (337) 594-8958 |
NPI Number | 1558485235 |
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Provider Enumeration Date | 03/19/2007 |
Last Update Date | 03/13/2017 |
Medicare PECOS PAC ID | 8729031760 |
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Medicare Enrollment ID | O20050302000078 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558485235 | NPI | - | NPPES |
1422991 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 024917 (Louisiana) | Primary |
Provider Name | Lee D Ellender |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1558364331 PECOS PAC ID: 1153370986 Enrollment ID: I20050119000095 |
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