Suleman Primary Care Llc | |
200 W Esplanade Ave Ste 307 Kenner LA 70065-2474 | |
(504) 641-4461 | |
(504) 712-8879 |
Full Name | Suleman Primary Care Llc |
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Speciality | Clinic/Center |
Location | 200 W Esplanade Ave Ste 307, Kenner, Louisiana |
Authorized Official Name and Position | Samia Suleman (OWNER) |
Authorized Official Contact | 5046414461 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Suleman Primary Care Llc 200 W Esplanade Ave Ste 312 Kenner LA 70065-2474 Ph: (504) 641-4461 | Suleman Primary Care Llc 200 W Esplanade Ave Ste 307 Kenner LA 70065-2474 Ph: (504) 641-4461 |
NPI Number | 1538739016 |
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Provider Enumeration Date | 06/28/2021 |
Last Update Date | 06/28/2021 |
Medicare PECOS PAC ID | 6406259076 |
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Medicare Enrollment ID | O20210721000436 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538739016 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Samia Suleman |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1902216948 PECOS PAC ID: 9537588512 Enrollment ID: I20200924000226 |
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