Church Point Medical Clinic Llc

LBN: Church Point Medical Clinic Llc
Church Point Medical Clinic Llc is an health care organization with primary practice located at 731 S Main St Suite A, Church Point LA 70525-4109. The organization recently has only one registered license in Ambulatory Health Care Facilities / Medical Specialty, which is considered as the primary health care specialty. Church Point Medical Clinic Llc can be contacted via phone (337) 684-0911, or through Polanco, Marcelo via phone (337) 684-0911.

Contact Information

Primary practice address
731 S Main St Suite A Church Point LA 70525-4109
Phone: (337) 684-0911
Fax: (337) 684-0912
Website:
Map and Directions
Authorized official contact:
Name: Polanco, Marcelo Doctor of Medicine (MD)
Phone: (337) 684-0911

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Medical Specialty 261QM2500X LA023828 Louisiana

Profile Details

NPI number 1114144888
LBN Legal business name Church Point Medical Clinic Llc
DBA Doing business as
Authorized official Polanco, Marcelo Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 20th, 2007
Last updated Jun 21st, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114144888 NPPES
Louisiana MEDICAID 1485438

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