MEDICARE: CENLA RURAL HEALTH CENTERS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275566986
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENLA RURAL HEALTH CENTERS, LLC

Provider Business Mailing Address
First Line	:	220 ADAMS PATH
Second Line	:
City	:	PINEVILLE
State	:	LA
Zip	:	71360-7903
Country	:	US
Telephone Number	:	318-308-9950
Fax Number	:

Provider Business Practice Location Address
First Line	:	340 WEBB SMITH DR
Second Line	:
City	:	COLFAX
State	:	LA
Zip	:	71417-1910
Country	:	US
Telephone Number	:	318-627-3700
Fax Number	:	318-627-3545

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MR. SANDY L PILAND SR.
Credential	:
Telephone Number	:	318-627-3700

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	04/07/2011

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