| L.a. Medical Llc | |
|
107 S 16th St Unionville MO 63565-1624 | |
| (660) 947-4191 | |
| (660) 947-4091 |
| Full Name | L.a. Medical Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 107 S 16th St, Unionville, Missouri |
| Authorized Official Name and Position | Lawrence Allen (OFFICE MANAGER) |
| Authorized Official Contact | 6609474191 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| L.a. Medical Llc 107 S 16th St Unionville MO 63565-1624 Ph: (660) 947-4191 | L.a. Medical Llc 107 S 16th St Unionville MO 63565-1624 Ph: (660) 947-4191 |
| NPI Number | 1235731233 |
|---|---|
| Provider Enumeration Date | 11/13/2020 |
| Last Update Date | 01/28/2021 |
| Medicare PECOS PAC ID | 0941614077 |
|---|---|
| Medicare Enrollment ID | O20210201000175 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235731233 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Elizabeth M Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871039917 PECOS PAC ID: 8022391143 Enrollment ID: I20170215000113 |
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