| Premise Health Of Louisiana Medical Professional Medical Corporation | |
|
14902 River Rd Norco LA 70079-2543 | |
| (985) 764-4666 | |
| (985) 764-4568 |
| Full Name | Premise Health Of Louisiana Medical Professional Medical Corporation |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 14902 River Rd, Norco, Louisiana |
| Authorized Official Name and Position | Jonathan B Leizman (PRESIDENT) |
| Authorized Official Contact | 6154686270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premise Health Of Louisiana Medical Professional Medical Corporation 5500 Maryland Way Ste 120 Brentwood TN 37027-4993 Ph: () - | Premise Health Of Louisiana Medical Professional Medical Corporation 14902 River Rd Norco LA 70079-2543 Ph: (985) 764-4666 |
| NPI Number | 1609698877 |
|---|---|
| Provider Enumeration Date | 10/29/2024 |
| Last Update Date | 10/29/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609698877 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
St Charles Community Health Center, Norco Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 16004 River Rd, Norco, LA 70079 Phone: 985-725-9330 Fax: 504-575-3691 |