Healthcare Provider Details

I. General information

NPI: 1326230988
Provider Name (Legal Business Name): PACER HEALTH MANAGEMENT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2007
Last Update Date: 03/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5360 WEST CREOLE HWY
CAMERON LA
70631-5127
US

IV. Provider business mailing address

5360 WEST CREOLE HWY
CAMERON LA
70631-5127
US

V. Phone/Fax

Practice location:
  • Phone: 337-542-4111
  • Fax: 606-545-4863
Mailing address:
  • Phone: 337-542-4111
  • Fax: 606-545-4863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number StateLA

VIII. Authorized Official

Name: MR. RAY L SHOEMAKER
Title or Position: CEO
Credential:
Phone: 662-840-0196