| |
1016 Main Street Patterson LA 70392 | |
(985) 263-1216 | |
(985) 263-1217 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1016 Main Street, Patterson, Louisiana |
Authorized Official Name and Position | Mary R Leblanc (OWNER) |
Authorized Official Contact | 9852631216 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 2985 Patterson LA 70392-2985 Ph: (985) 263-1216 | 1016 Main Street Patterson LA 70392 Ph: (985) 263-1216 |
NPI Number | 1801471156 |
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Provider Enumeration Date | 03/17/2021 |
Last Update Date | 10/10/2023 |
Medicare PECOS PAC ID | 8729485040 |
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Medicare Enrollment ID | O20210928003608 |
Identifier | Type | State | Issuer |
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1801471156 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |