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13801 Pride-port Hudson Road Pride LA 70770 | |
(225) 343-9505 | |
(225) 343-9141 |
Full Name | |
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Speciality | Clinic/center |
Location | 13801 Pride-port Hudson Road, Pride, Louisiana |
Authorized Official Name and Position | Sue Catchings (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 2257656690 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 64749 Baton Rouge LA 70896-4749 Ph: (225) 343-9505 | 13801 Pride-port Hudson Road Pride LA 70770 Ph: (225) 343-9505 |
NPI Number | 1427275502 |
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Provider Enumeration Date | 04/19/2007 |
Last Update Date | 03/22/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427275502 | NPI | - | NPPES |
1446297 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |