| Hargroder Medical, Inc. | |
|
3501 Highway 190 Ste X Eunice LA 70535-5129 | |
| (337) 580-7544 | |
| (337) 580-7621 |
| Full Name | Hargroder Medical, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 3501 Highway 190 Ste X, Eunice, Louisiana |
| Authorized Official Name and Position | Ty Glenn Hargroder (PRESIDENT) |
| Authorized Official Contact | 3376845232 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hargroder Medical, Inc. Po Box 407 Church Point LA 70525-0407 Ph: (337) 684-5232 | Hargroder Medical, Inc. 3501 Highway 190 Ste X Eunice LA 70535-5129 Ph: (337) 580-7544 |
| NPI Number | 1356484703 |
|---|---|
| Provider Enumeration Date | 02/15/2007 |
| Last Update Date | 05/16/2023 |
| Medicare PECOS PAC ID | 4385730241 |
|---|---|
| Medicare Enrollment ID | O20071023000766 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356484703 | NPI | - | NPPES |
| 1038458 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 020601 (Louisiana) | Primary |
| Provider Name | Lisa A Jaubert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780703710 PECOS PAC ID: 9739097106 Enrollment ID: I20070615000597 |
| Provider Name | Ty G. Hargroder |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1093761645 PECOS PAC ID: 0749376606 Enrollment ID: I20071106000710 |
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