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General NPI Number Information
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NPI Number | 1609234012
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Entity Type | Organization
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Legal Business Name | SAVOY MEDICAL MANAGEMENT GROUP, INC
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Dates
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Enumeration Date | 02/01/2016
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Last Update Date | 08/08/2022
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Provider Practice Location Address
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Address Line | 1431 FUSELIER AVE
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City | BASILE
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State | LA
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Zip | 70515-5583
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Country | US
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Telephone | 337-432-0200
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Fax | 337-432-0202
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Provider Business Mailing Address
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Address Line | 801 POINCIANA AVE
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City | MAMOU
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State | LA
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Zip | 70554-2243
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Country | US
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Telephone | 337-432-0200
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Fax | 337-432-0202
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL W. JOHNSON
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Credential | CPA
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Telephone | 337-468-0355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 2203783121
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License Number State | LA
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