| Northwest Louisiana Family Care, Llc | |
|
2 Medical Plaza Pl Minden LA 71055-3330 | |
| (318) 377-0587 | |
| Not Available |
| Full Name | Northwest Louisiana Family Care, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 2 Medical Plaza Pl, Minden, Louisiana |
| Authorized Official Name and Position | Sallie Lee Bethea (OWNER) |
| Authorized Official Contact | 3183770587 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Louisiana Family Care, Llc 2 Medical Plaza Pl Minden LA 71055-3330 Ph: (318) 377-0587 | Northwest Louisiana Family Care, Llc 2 Medical Plaza Pl Minden LA 71055-3330 Ph: (318) 377-0587 |
| NPI Number | 1467509232 |
|---|---|
| Provider Enumeration Date | 01/04/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467509232 | NPI | - | NPPES |
| 1442429 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | APO 03674 (Louisiana) | Primary |
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