Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 104 Morris Cir, Homer, Louisiana |
Authorized Official Name and Position | Anna Lee Jones (CHIEF QUALITY AND INTEGRATION OFFIC) |
Authorized Official Contact | 3189272024 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
620 E College St Homer LA 71040-3202 Ph: (318) 927-2024 | 104 Morris Cir Homer LA 71040-2109 Ph: (318) 927-6777 |
NPI Number | 1811580145 |
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Provider Enumeration Date | 02/17/2021 |
Last Update Date | 03/08/2021 |
Medicare PECOS PAC ID | 1456322692 |
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Medicare Enrollment ID | O20210405001123 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811580145 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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