| Louviere Enterprises, Inc. | |
|
386 Carriage House Dr Ste D Jackson TN 38305 | |
| (731) 664-8874 | |
| (731) 664-8932 |
| Full Name | Louviere Enterprises, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 386 Carriage House Dr Ste D, Jackson, Tennessee |
| Authorized Official Name and Position | Kelia C Ingram (OWNER PRESIDENT) |
| Authorized Official Contact | 7316648874 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Louviere Enterprises, Inc. 386 Carriage House Dr Ste D Jackson TN 38305-2236 Ph: (731) 664-8874 | Louviere Enterprises, Inc. 386 Carriage House Dr Ste D Jackson TN 38305 Ph: (731) 664-8874 |
| NPI Number | 1144284662 |
|---|---|
| Provider Enumeration Date | 04/13/2006 |
| Last Update Date | 09/21/2021 |
| Certification Date | 09/21/2021 |
| Medicare PECOS PAC ID | 9032293436 |
|---|---|
| Medicare Enrollment ID | O20080225000164 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144284662 | NPI | - | NPPES |
| 4218325 | Other | BCBS TN |
| Provider Name | Amado Freire |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1447217401 PECOS PAC ID: 5294887709 Enrollment ID: I20090714000699 |
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