Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 805 Cherry St, Mamou, Louisiana |
Authorized Official Name and Position | Medha Upendra Kulkarni (ADMINISTRATOR) |
Authorized Official Contact | 3374590481 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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805 Cherry St Mamou LA 70554-2223 Ph: (337) 468-2250 | 805 Cherry St Mamou LA 70554-2223 Ph: (337) 468-2250 |
NPI Number | 1972950996 |
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Provider Enumeration Date | 05/19/2016 |
Last Update Date | 03/06/2018 |
Medicare PECOS PAC ID | 6406996602 |
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Medicare Enrollment ID | O20180305000570 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972950996 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
John Phil Fontenot, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1415 7th St, Suite K, Mamou, LA 70554 Phone: 337-468-5150 Fax: 337-468-5155 | |
Christopher Cutter Md Inc A Professional Medical Corportation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 704 Poinciana Ave, Suite C, Mamou, LA 70554 Phone: 337-468-4038 Fax: 337-468-4042 |