# MEDAMERICA LLC

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

## Provider details

- **NPI number:** 1407901978
- **Authorized official:** DEWITT GINN (OWNER OFFICE MANAGER)
- **Authorized official phone:** (225) 654-4290

## Contact information

- **Practice address:** 9305 MAIN ST, SUITE D, ZACHARY, LA 70791-7441
- **Practice address phone:** (225) 654-4290
- **Practice address fax:** (225) 654-0102
- **Mailing address:** 9305 MAIN ST, SUITE D, ZACHARY, LA 70791-7441
- **Mailing address phone:** (225) 654-4290
- **Mailing address fax:** (225) 654-0102

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | 1416142 | LA | Yes |

## Other

- **Enumeration date:** 01/24/2007
- **Last updated:** 08/22/2020