PELICAN STATE OUTPATIENT CENTER - CARO CLINIC L. L. C. (NPI# 1467507913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1467507913 |
Entity Type | Organization |
Organization Name | PELICAN STATE OUTPATIENT CENTER - CARO CLINIC L. L. C. |
Other Organization Name | P. S. O. C. - CARO CLINIC |
Practice Address |
2304 S Burnside Ave Ste 2 Gonzales LA 70737-4664 |
Mailing Address |
Po Box 1499 Gonzales LA 70707-1499 |
Practice Telephone | 2256476533 |
Practice Fax Number | 2256447533 |
Mailing Telephone | 2256476533 |
Mailing Fax Number | 2256447533 |
Enumeration Date | 2007-01-24 |
Last Update Date | 2018-11-27 |
Authorized Official Name | PETER J. MONTEYNE (MEMBER OWNER) |
Authorized Official Telephone | 2256476533 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
P. S. O. C. - CARO CLINIC | Doing Business As Name - Organization |
Street Address |
2304 S BURNSIDE AVE STE 2 |
City | GONZALES |
State | LA |
Zip Code | 70737-4664 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407461593 | Scott G Petrie Md Apmc | Non-Pharmacy Dispensing Site | 1014 West St Clare Boulevard, Ste 1020, Gonzales, LA 70737 | 2020-09-15 |
1407461981 | Bryant Louis Bourgeois | Dentist | 13317 N Burnside, Gonzales, LA 70737 | 2020-09-11 |
1821612631 | Kene Anje Hamilton | Behavioral Analyst | 1028 East Worthy Street, Gonzales, LA 70737 | 2020-06-08 |
1801428636 | Mercedes Francis | Behavior Technician | 1023 E W Worthy Rd, Gonzales, LA 70737 | 2020-02-10 |
1407347586 | Functional Dme | Prosthetic/Orthotic Supplier | 219 W. Eastbank St., Ste B, Gonzales, LA 70737 | 2018-05-23 |
1235631789 | Transporting On Purpose | Non-emergency Medical Transport (VAN) | 42148 Conifer Drive, Gonzales, LA 70737 | 2018-03-01 |
1215453121 | Michelle Fuller Harris | Social Worker | 39094 N Angelle Ct, Gonzales, LA 70737 | 2017-08-22 |
1215452529 | Lani Litchfield | Specialist/Technologist | 13341 W. Mill Grove Dr, Gonzales, LA 70737 | 2017-08-08 |
1326569369 | Tyler Joshua Turner | Counselor | 1923 South Edwards, Gonzales, LA 70737 | 2017-06-29 |
1518408046 | Margaret Madere | Social Worker | 2827 S Ruby Street, Gonzales, LA 70737 | 2017-03-16 |
Find all providers in zip 70737 |
Taxonomy Code | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184176158 | Gonzales Medical Center, Inc | Clinic/Center | 18 Fourth Street, Gonzales, CA 93926-0808 | 2016-10-26 |
1104856913 | Dominador C Gines Jr. | Clinic/Center | 132 Alta Street, Gonzales, CA 93926-3005 | 2006-07-04 |
1578885240 | Adult Medicine Institute & Diagnostic Center | Clinic/Center | 1937 S Burnside Ave, Gonzales, LA 70737-4632 | 2010-02-23 |
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1124659164 | Diana L. Corley, Fnp, LLC | Clinic/Center | 1015 Hwy 107, Centerpoint, LA 71323 | 2020-01-29 |
1790322717 | Take Care Clinic LLC | Clinic/Center | 6721 Saint Claude Ave Ste B, Arabi, LA 70032-1247 | 2019-12-09 |
1518503754 | Optimus Primary Care, LLC | Clinic/Center | 13828 Coursey Boulevard, Address Line 2, Baton Rouge, LA 70817 | 2019-11-22 |
1992367791 | Family First Medical & Wellness Clinic, LLC | Clinic/Center | 300 Clay St, Kenner, LA 70062 | 2019-07-01 |
1366926040 | In and Out Urgent Care Covington, LLC | Clinic/Center | 13130 Hwy 1085, Suite 100, Covington, LA 70433-7829 | 2018-09-19 |
1588143556 | Pediatric Center of Many LLC | Clinic/Center | 315 S Highland Dr Ste A, Many, LA 71449-3719 | 2018-08-10 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.