| Louisiana Care Services, Llc | |
|
103 W Martial Ave Lafayette LA 70508-6719 | |
| (337) 981-5335 | |
| Not Available |
| Full Name | Louisiana Care Services, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 103 W Martial Ave, Lafayette, Louisiana |
| Authorized Official Name and Position | Lisha C Falk (VP OF CONTRACTING) |
| Authorized Official Contact | 8008939696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Louisiana Care Services, Llc 200 Corporate Blvd Lafayette LA 70508-3870 Ph: (800) 893-9698 | Louisiana Care Services, Llc 103 W Martial Ave Lafayette LA 70508-6719 Ph: (337) 981-5335 |
| NPI Number | 1538789540 |
|---|---|
| Provider Enumeration Date | 04/20/2020 |
| Last Update Date | 05/17/2021 |
| Medicare PECOS PAC ID | 5092146621 |
|---|---|
| Medicare Enrollment ID | O20200514000486 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538789540 | NPI | - | NPPES |
| Provider Name | Garth T King |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598775355 PECOS PAC ID: 8628077302 Enrollment ID: I20061206000268 |
| Provider Name | Corey Grant Lauchner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447538335 PECOS PAC ID: 0446429260 Enrollment ID: I20110812000420 |
| Provider Name | Nicole M Lavergne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811319114 PECOS PAC ID: 0749503498 Enrollment ID: I20150105000047 |
| Provider Name | Jessie S Iles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619337367 PECOS PAC ID: 6507155033 Enrollment ID: I20160614001151 |
| Provider Name | Kimberly Chu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699131342 PECOS PAC ID: 8729371810 Enrollment ID: I20160727001071 |
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