West Carroll Medical Clinic | |
502 Ross St Oak Grove LA 71263-9706 | |
(318) 428-2358 | |
(318) 428-2350 |
Full Name | West Carroll Medical Clinic |
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Speciality | Clinic/Center |
Location | 502 Ross St, Oak Grove, Louisiana |
Authorized Official Name and Position | Dewana Little (ADMINISTRATOR) |
Authorized Official Contact | 3184283237 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
West Carroll Medical Clinic 706 Ross St Oak Grove LA 71263-9798 Ph: (318) 428-2358 | West Carroll Medical Clinic 502 Ross St Oak Grove LA 71263-9706 Ph: (318) 428-2358 |
NPI Number | 1780667766 |
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Provider Enumeration Date | 11/23/2005 |
Last Update Date | 12/12/2023 |
Medicare PECOS PAC ID | 5294627774 |
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Medicare Enrollment ID | O20040728000189 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780667766 | NPI | - | NPPES |
1943941 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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