Southcare Medical Llc
LBN: Southcare Medical Llc
Southcare Medical Llc is an health care organization with primary practice located at 110 Curran Ln , Lafayette LA 70506. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Ambulatory Health Care Facilities / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Family. Ambulatory Health Care Facilities / Primary Care is the primary health care specialty.
Southcare Medical Llc can be contacted via phone (337) 706-7700, or through Sugeng, Budi via phone (337) 422-6240.
Contact Information
Primary practice address
110 Curran Ln
Lafayette LA 70506
Phone: (337) 706-7700
Fax: (337) 706-7710
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD200292 | Louisiana |
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | AP07807 | Louisiana |
Profile Details
| NPI number | 1093170433 |
|---|---|
| LBN Legal business name | Southcare Medical Llc |
| DBA Doing business as | |
| Authorized official | Sugeng, Budi Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 30th, 2015 |
| Last updated | Oct 5th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093170433 | NPPES |
| Louisiana | Other | 19D2091426 | CLIA WAIVER |
| Louisiana | MEDICAID | 2409930 | CLIA WAIVER |
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