Organization
CALCASIEU URGENT CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYDNI CLEMMONS (CREDENTIALING MANAGER)
(901) 351-1791
Entity
Organization
Contact information
Practice address
1017 N PINE STREET, DERIDDER, LA 70634
(337) 426-0919
(337) 426-0931
Mailing address
3995 COUNTY ROAD 36, KILLEN, AL 35645-4651
(901) 351-1791
(337) 426-0931
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
LA
Enumeration date
10/05/2018
Last updated
06/22/2021
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