| |
1111 Homer Rd Minden LA 71055-3027 | |
(318) 377-7500 | |
(318) 371-3594 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1111 Homer Rd, Minden, Louisiana |
Authorized Official Name and Position | Richard T. Merk (OFFICER/AUTHORIZED OFFICIAL) |
Authorized Official Contact | 3182268202 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1111 Homer Rd Minden LA 71055-3027 Ph: (318) 377-7500 | 1111 Homer Rd Minden LA 71055-3027 Ph: (318) 377-7500 |
NPI Number | 1699834473 |
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Provider Enumeration Date | 12/07/2006 |
Last Update Date | 08/19/2020 |
Medicare PECOS PAC ID | 4789720004 |
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Medicare Enrollment ID | O20170722000035 |
Identifier | Type | State | Issuer |
---|---|---|---|
1699834473 | NPI | - | NPPES |
1043630 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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Minden Family Care Center, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 208 Morris Dr, Minden, LA 71055 Phone: 318-377-8260 Fax: 318-377-9053 | |
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