MEDICARE: LAROUGE HEALTHCARE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	251S00000X	Community/Behavioral Health Agency
3	261QM1300X	Multi-Specialty Clinic/Center
4	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1669074159
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAROUGE HEALTHCARE

Provider Business Mailing Address
First Line	:	PO BOX 485
Second Line	:
City	:	BAKER
State	:	LA
Zip	:	70704-0485
Country	:	US
Telephone Number	:	225-955-1707
Fax Number	:	225-341-8763

Provider Business Practice Location Address
First Line	:	9800 AIRLINE HWY STE 233
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-8195
Country	:	US
Telephone Number	:	833-262-1101
Fax Number	:	844-927-4527

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	EBONY BROWN
Credential	:
Telephone Number	:	833-262-1101

Provider Enumeration Date	:	11/10/2020
Last Update Date	:	12/20/2022

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Directions to “LAROUGE HEALTHCARE ” Practice Location

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