Provider Demographics
NPI:1548290745
Name:MED-CARE OF ASCENSION LLC
Entity type:Organization
Organization Name:MED-CARE OF ASCENSION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAY
Authorized Official - Middle Name:
Authorized Official - Last Name:TALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-647-3500
Mailing Address - Street 1:201 WEST EASTBANK DRIVE
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-3702
Mailing Address - Country:US
Mailing Address - Phone:225-647-3500
Mailing Address - Fax:225-644-1234
Practice Address - Street 1:201 WEST EASTBANK DR
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737
Practice Address - Country:US
Practice Address - Phone:225-647-3500
Practice Address - Fax:225-644-1234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA043703145332B00000X
LA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1548290745OtherAMERIHEALTH CARITAS
LA1548290745OtherLOUISIANA HEALTHCARE CONNECTIONS
LA1548290745OtherHEALTHY BLUE
LA1548290745OtherHMO BLUE ADVANTAGE PLAN
LA1672939Medicaid
LA286286OtherWELLCARE
LA1548290745OtherUNITED HEALTHCARE COMMUNITY PLAN
LA1548290745OtherAETNA BETTER HEALTH PLAN
LA286286OtherWELLCARE
LA1548290745OtherLOUISIANA HEALTHCARE CONNECTIONS