Organization
ICP LOUISIANA ACO BILLING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARGARET S PEMBERTON (VICE PRESIDENT)
(502) 394-2100
Entity
Organization
Contact information
Practice address
333 TEXAS ST STE 1300, SHREVEPORT, LA 71101-3783
(800) 807-6555
(855) 316-2999
Mailing address
805 N WHITTINGTON PKWY STE 200, LOUISVILLE, KY 40222-7102
(800) 807-6555
(855) 316-2999
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/12/2021
Last updated
11/11/2025
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