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NPI Code Detail

MEDICARE: COMMCARE CORPORATION

MEDICARE: COMMCARE CORPORATION
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
1314000000XSkilled Nursing Facility156LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
134421OTHERLABLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316905870
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMCARE CORPORATION
Provider Business Mailing Address
First Line : 1616 WELLERMAN RD
Second Line :
City : WEST MONROE
State : LA
Zip : 71291-7427
Country : US
Telephone Number : 318-387-2577
Fax Number : 318-325-8662
Provider Business Practice Location Address
First Line : 1616 WELLERMAN RD
Second Line :
City : WEST MONROE
State : LA
Zip : 71291-7427
Country : US
Telephone Number : 318-387-2577
Fax Number : 318-325-8662
Authorized Official
Title or Position : VICE PRESIDENT, CAO
Name : DAWN HARVEY PSARELLIS
Credential :
Telephone Number : 504-324-8950
Provider Enumeration Date : 05/03/2006
Last Update Date : 02/18/2021

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Directions to “COMMCARE CORPORATION ” Practice Location

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