St. James Primary Care (apmc) | |
827 Pine St Gramercy LA 70052-3659 | |
(225) 869-9200 | |
(225) 869-9241 |
Full Name | St. James Primary Care (apmc) |
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Speciality | Clinic/Center |
Location | 827 Pine St, Gramercy, Louisiana |
Authorized Official Name and Position | Anu Prasad Vellanki (M.D.) |
Authorized Official Contact | 2258699200 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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St. James Primary Care (apmc) Po Box 419 Gramercy LA 70052-0419 Ph: (225) 869-9200 | St. James Primary Care (apmc) 827 Pine St Gramercy LA 70052-3659 Ph: (225) 869-9200 |
NPI Number | 1164428629 |
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Provider Enumeration Date | 06/21/2005 |
Last Update Date | 06/14/2012 |
Medicare PECOS PAC ID | 0941270961 |
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Medicare Enrollment ID | O20060320000346 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164428629 | NPI | - | NPPES |
5CE42 | Other | LA | MEDICARE GROUP |
057843586A | Other | LA | BLUE CROSS BLUE SHIELD |
1448800 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 110 (Louisiana) | Primary |
St. James Primary Care, Apmc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 827 N Pine St, Gramercy, LA 70052 Phone: 225-869-9200 | |
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