| Lafourche Parish Hospital Service District No. 1 | |
|
13030 Highway 308 Larose LA 70345-4143 | |
| (985) 798-7000 | |
| (985) 798-7021 |
| Full Name | Lafourche Parish Hospital Service District No. 1 |
|---|---|
| Speciality | Clinic/Center |
| Location | 13030 Highway 308, Larose, Louisiana |
| Authorized Official Name and Position | Tad A Lafont (CHIEF CLINIC OFFCIER) |
| Authorized Official Contact | 9856326401 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lafourche Parish Hospital Service District No. 1 13030 Highway 308 Larose LA 70373-2056 Ph: (985) 798-7000 | Lafourche Parish Hospital Service District No. 1 13030 Highway 308 Larose LA 70345-4143 Ph: (985) 798-7000 |
| NPI Number | 1932256542 |
|---|---|
| Provider Enumeration Date | 01/04/2007 |
| Last Update Date | 03/24/2023 |
| Medicare PECOS PAC ID | 2264342229 |
|---|---|
| Medicare Enrollment ID | O20040331000277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932256542 | NPI | - | NPPES |
| 1457671 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Camille C Pitre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073568341 PECOS PAC ID: 7113996075 Enrollment ID: I20040928000293 |
| Provider Name | Lenny A Folse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801836135 PECOS PAC ID: 6507871472 Enrollment ID: I20060214000290 |
| Provider Name | Duane J Luke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164429544 PECOS PAC ID: 1355436361 Enrollment ID: I20071005000571 |
| Provider Name | John G Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063497683 PECOS PAC ID: 7719950096 Enrollment ID: I20080227000214 |
| Provider Name | Rachelle R Guidry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679028260 PECOS PAC ID: 5496022766 Enrollment ID: I20170517002323 |
| Provider Name | Amanda Olivier Rogers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073977054 PECOS PAC ID: 1355649682 Enrollment ID: I20190808002020 |
Jay Vega Md.,a.p.m.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13030 Highway 308, Larose, LA 70373 Phone: 985-798-5611 Fax: 985-798-5648 |