Healthcare Provider Details

I. General information

NPI: 1285488304
Provider Name (Legal Business Name): PCP URGENT CARE HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2024
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1706 SW RAILROAD AVE
HAMMOND LA
70403-6146
US

IV. Provider business mailing address

8540 SIEGEN LN STE B
BATON ROUGE LA
70810-2372
US

V. Phone/Fax

Practice location:
  • Phone: 985-826-7782
  • Fax: 985-318-7163
Mailing address:
  • Phone: 225-224-8690
  • Fax: 225-615-7704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVEN EDWARD PRESLEY
Title or Position: CHIEF STRATEGY OFFICER
Credential: PA-C
Phone: 225-663-6827