# MAIN STREET CLINIC, LLC

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

## Provider details

- **NPI number:** 1396022034
- **Authorized official:** MS. LAURA G CUMMINGS FNP (OWNER, PROVIDER)
- **Authorized official phone:** (318) 649-3668

## Contact information

- **Practice address:** 115 MAIN ST, COLUMBIA, LA 71418
- **Practice address phone:** (318) 649-3668
- **Mailing address:** PO BOX 1615, COLUMBIA, LA 71418-1615
- **Mailing address phone:** (318) 649-3668
- **Mailing address fax:** (318) 649-0086

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/09/2011
- **Last updated:** 11/23/2011