| Independence Family Clinic Llc | |
|
312 E Railroad Ave Independence LA 70443-2710 | |
| (985) 878-4183 | |
| Not Available |
| Full Name | Independence Family Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 312 E Railroad Ave, Independence, Louisiana |
| Authorized Official Name and Position | Bryan Dale Tate (MANAGER) |
| Authorized Official Contact | 9858784183 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Independence Family Clinic Llc 312 E Railroad Ave Independence LA 70443-2710 Ph: (985) 878-4183 | Independence Family Clinic Llc 312 E Railroad Ave Independence LA 70443-2710 Ph: (985) 878-4183 |
| NPI Number | 1922876960 |
|---|---|
| Provider Enumeration Date | 12/19/2023 |
| Last Update Date | 04/23/2025 |
| Medicare PECOS PAC ID | 1951845494 |
|---|---|
| Medicare Enrollment ID | O20240626000773 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922876960 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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