Healthcare Gallery Llc | |
3488 Brentwood Dr Suite 103 Baton Rouge LA 70809-1639 | |
(617) 308-9499 | |
Not Available |
Full Name | Healthcare Gallery Llc |
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Speciality | Family Medicine |
Location | 3488 Brentwood Dr, Baton Rouge, Louisiana |
Authorized Official Name and Position | Leone Elliott (OWNER) |
Authorized Official Contact | 2253845378 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Healthcare Gallery Llc 3488 Brentwood Dr Suite 103 Baton Rouge LA 70809-1639 Ph: (617) 308-9499 | Healthcare Gallery Llc 3488 Brentwood Dr Suite 103 Baton Rouge LA 70809-1639 Ph: (617) 308-9499 |
NPI Number | 1366878076 |
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Provider Enumeration Date | 09/25/2013 |
Last Update Date | 04/10/2023 |
Medicare PECOS PAC ID | 8820498884 |
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Medicare Enrollment ID | O20210611002333 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366878076 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
261QP2300X | Clinic/center - Primary Care | 025912 (Louisiana) | Secondary |
Provider Name | Leone F Elliott |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1609805381 PECOS PAC ID: 0446217137 Enrollment ID: I20041214000899 |
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