| Family Healthcare Of Bedico, Llc | |
|
27455 Highway 22 Ste B Ponchatoula LA 70454-8107 | |
| (985) 206-9877 | |
| (985) 206-9875 |
| Full Name | Family Healthcare Of Bedico, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 27455 Highway 22 Ste B, Ponchatoula, Louisiana |
| Authorized Official Name and Position | Travis King (OWNER, MANAGER) |
| Authorized Official Contact | 9853207156 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Healthcare Of Bedico, Llc 42378 Ott Ln Hammond LA 70403-3232 Ph: (985) 320-7156 | Family Healthcare Of Bedico, Llc 27455 Highway 22 Ste B Ponchatoula LA 70454-8107 Ph: (985) 206-9877 |
| NPI Number | 1609439884 |
|---|---|
| Provider Enumeration Date | 04/15/2019 |
| Last Update Date | 03/20/2023 |
| Medicare PECOS PAC ID | 4385003862 |
|---|---|
| Medicare Enrollment ID | O20230630000996 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609439884 | NPI | - | NPPES |
| 2194089 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
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