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22080 La Hwy 20 Vacherie LA 70090-0069 | |
(225) 265-3061 | |
(225) 265-3062 |
Full Name | |
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Speciality | Clinic/Center |
Location | 22080 La Hwy 20, Vacherie, Louisiana |
Authorized Official Name and Position | Raja S Talluri (PRESIDENT) |
Authorized Official Contact | 2252653061 |
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 69 Vacherie LA 70090-0069 Ph: (225) 265-3061 | 22080 La Hwy 20 Vacherie LA 70090-0069 Ph: (225) 265-3061 |
NPI Number | 1255348843 |
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Provider Enumeration Date | 08/03/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 9335189109 |
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Medicare Enrollment ID | O20050511000427 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255348843 | NPI | - | NPPES |
1449792 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 098 (Louisiana) | Primary |
Access Health Louisiana Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3125 Valcour Aime St, Vacherie, LA 70090 Phone: 866-530-6111 | |
Sarat K Donepudi Md Apmc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 21420 Highway 20, Vacherie, LA 70090 Phone: 225-265-3013 Fax: 225-265-3775 | |
Teche Action Board, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 22187 Highway 20, Vacherie, LA 70090 Phone: 225-258-4980 |