Organization
MED-CARE OF ASCENSION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAY TALLEY (OWNER)
(225) 647-3500
Entity
Organization
Contact information
Practice address
201 WEST EASTBANK DR, GONZALES, LA 70737
(225) 647-3500
(225) 644-1234
Mailing address
201 WEST EASTBANK DRIVE, GONZALES, LA 70737-3702
(225) 647-3500
(225) 644-1234
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
043703145
LA
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548290745
AMERIHEALTH CARITAS
LA
05
—
1672939
—
LA
01
—
286286
WELLCARE
LA
Enumeration date
07/03/2006
Last updated
07/21/2022
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