| Lady Of The Sea Medical Clinic - Golden Meadow | |
|
176 Washington St Golden Meadow LA 70357-2938 | |
| (985) 475-5200 | |
| (985) 475-5664 |
| Full Name | Lady Of The Sea Medical Clinic - Golden Meadow |
|---|---|
| Speciality | Family Medicine |
| Location | 176 Washington St, Golden Meadow, Louisiana |
| Authorized Official Name and Position | Tad A. Lafont (DIRECTOR OF PRACTICE MANAGEMENT) |
| Authorized Official Contact | 9853259300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lady Of The Sea Medical Clinic - Golden Meadow 176 Washington St Golden Meadow LA 70357-2938 Ph: (985) 475-5200 | Lady Of The Sea Medical Clinic - Golden Meadow 176 Washington St Golden Meadow LA 70357-2938 Ph: (985) 475-5200 |
| NPI Number | 1376590430 |
|---|---|
| Provider Enumeration Date | 05/27/2006 |
| Last Update Date | 01/11/2022 |
| Medicare PECOS PAC ID | 2264342229 |
|---|---|
| Medicare Enrollment ID | O20040115000353 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376590430 | NPI | - | NPPES |
| 1459259 | Medicaid | LA | |
| 5CH34 | Other | LA | MEDICARE PART B |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Lenny A Folse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801836135 PECOS PAC ID: 6507871472 Enrollment ID: I20060214000290 |
| Provider Name | Rachelle R Guidry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679028260 PECOS PAC ID: 5496022766 Enrollment ID: I20170517002323 |
Lady Of The Sea Medical Clinic - Fourchon Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 180-b A.o. Rappelet Road, Golden Meadow, LA 70357 Phone: 985-396-5250 Fax: 985-396-5252 |