MEDICARE: FCC POLLOCK

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	261QP2400X	Prison Health Clinic/Center

General Provider Information

NPI Number	:	1881821247
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FCC POLLOCK

Provider Business Mailing Address
First Line	:	P.O. 1000
Second Line	:	HEALTH SERVICES
City	:	POLLOCK
State	:	LA
Zip	:	71467-1000
Country	:	US
Telephone Number	:	318-561-5546
Fax Number	:	318-561-5547

Provider Business Practice Location Address
First Line	:	1000 AIR BASE ROAD
Second Line	:	HEALTH SERVICES
City	:	POLLOCK
State	:	LA
Zip	:	71467-1000
Country	:	US
Telephone Number	:	318-561-5546
Fax Number	:	318-561-5547

Authorized Official
Title or Position	:	HEALTH SERVICES ADMINISTRATOR
Name	:	MR. SPENCER TALMADGE SMITH
Credential	:	RN
Telephone Number	:	318-561-5546

Provider Enumeration Date	:	06/12/2009
Last Update Date	:	06/12/2009

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1558355578 — BRUCE L CRAIG MD FAAFP
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1790714871 — WOODS HAVEN NURSING CARE AND REHABILITATION
Practice Location Address:

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Directions to “FCC POLLOCK ” Practice Location

Language	Start Address	Practice Location

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