Jay Vega Md.,a.p.m.c. | |
13030 Highway 308 Larose LA 70373 | |
(985) 798-5611 | |
(985) 798-5648 |
Full Name | Jay Vega Md.,a.p.m.c. |
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Speciality | Clinic/Center |
Location | 13030 Highway 308, Larose, Louisiana |
Authorized Official Name and Position | Jay Vega (PRESIDENT OWNER) |
Authorized Official Contact | 9857985611 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Jay Vega Md.,a.p.m.c. Po Box 508 Larose LA 70373-0508 Ph: (985) 798-5611 | Jay Vega Md.,a.p.m.c. 13030 Highway 308 Larose LA 70373 Ph: (985) 798-5611 |
NPI Number | 1740485754 |
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Provider Enumeration Date | 06/19/2007 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 4082689260 |
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Medicare Enrollment ID | O20040831001058 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740485754 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 10085R (Louisiana) | Primary |
Provider Name | Jay Jared Vega |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1457395659 PECOS PAC ID: 4789659962 Enrollment ID: I20040831001103 |
Lady Of The Sea Medical Clinic - Larose Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 13030 Highway 308, Larose, LA 70345 Phone: 985-798-7000 Fax: 985-798-7021 |