| Pelican State Outpatient Center - Caro Clinic L. L. C. | |
|
2304 S Burnside Ave Ste 2 Gonzales LA 70737-4664 | |
| (225) 647-6533 | |
| (225) 644-7533 |
| Full Name | Pelican State Outpatient Center - Caro Clinic L. L. C. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2304 S Burnside Ave Ste 2, Gonzales, Louisiana |
| Authorized Official Name and Position | Peter J. Monteyne (MEMBER OWNER) |
| Authorized Official Contact | 2256476533 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pelican State Outpatient Center - Caro Clinic L. L. C. Po Box 1499 Gonzales LA 70707-1499 Ph: (225) 647-6533 | Pelican State Outpatient Center - Caro Clinic L. L. C. 2304 S Burnside Ave Ste 2 Gonzales LA 70737-4664 Ph: (225) 647-6533 |
| NPI Number | 1467507913 |
|---|---|
| Provider Enumeration Date | 01/24/2007 |
| Last Update Date | 11/27/2018 |
| Medicare PECOS PAC ID | 8022051234 |
|---|---|
| Medicare Enrollment ID | O20100628000040 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467507913 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Peter J Monteyne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043222508 PECOS PAC ID: 9537102645 Enrollment ID: I20050609000060 |
| Provider Name | Richard J Caro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467519678 PECOS PAC ID: 3476580879 Enrollment ID: I20050718000557 |
| Provider Name | Brandi Lea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437108172 PECOS PAC ID: 9436163193 Enrollment ID: I20060201000736 |
| Provider Name | Gina T Jory |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104149905 PECOS PAC ID: 0648394619 Enrollment ID: I20100826001278 |
| Provider Name | Racine Dominique Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073216719 PECOS PAC ID: 5092169474 Enrollment ID: I20231004001283 |
Just Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1124 S Burnside Ave Ste 200a, Gonzales, LA 70737 Phone: 833-784-2669 Fax: 844-784-2329 | |
Action Therapy & Wellness Center, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 211 E Worthy Road, Bldg Iv, Gonzales, LA 70737 Phone: 255-644-7044 Fax: 225-644-4414 | |
Ascension Medical Clinic, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 214 S Burnside Ave Ste A, Gonzales, LA 70737 Phone: 225-647-6636 Fax: 225-647-3849 | |
Our Lady Of The Lake Ascension, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2647 S Riverview Blvd, Gonzales, LA 70737 Phone: 225-647-8511 Fax: 225-644-5213 | |
On-site Medical Solutions, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 37534 Highway 30 Ste A, Gonzales, LA 70737 Phone: 225-217-4344 Fax: 225-224-3523 | |
Harvey Pharmaceuticals 2 Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 416 N Burnside Ave, Gonzales, LA 70737 Phone: 225-416-7518 Fax: 225-433-0809 | |
Ochsner Clinic, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2400 S Burnside Ave, Gonzales, LA 70737 Phone: 225-709-2410 Fax: 225-709-2411 |