# ST. JAMES PRIMARY CARE, APMC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346429453
- **Authorized official:** DR. ANU PRASAD VELLANKI MD (DOCTOR)
- **Authorized official phone:** (225) 869-9200

## Contact information

- **Practice address:** 827 N PINE ST, GRAMERCY, LA 70052-3659
- **Practice address phone:** (225) 869-9200
- **Mailing address:** PO BOX 419, GRAMERCY, LA 70052-0419
- **Mailing address phone:** (225) 869-9200
- **Mailing address fax:** (225) 869-9241

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 1444111 | LA | Yes |

## Other

- **Enumeration date:** 10/25/2007
- **Last updated:** 06/29/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 057843586A | BLUE CROSS BLUE SHIELD | LA |