MEDICARE: GERIATRIC PROFESSIONAL SERVICES LLC

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	363LA2200X	Adult Health Nurse Practitioner

General Provider Information

NPI Number	:	1417665613
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GERIATRIC PROFESSIONAL SERVICES LLC

Provider Business Mailing Address
First Line	:	PO BOX 111
Second Line	:
City	:	COVINGTON
State	:	LA
Zip	:	70434-0111
Country	:	US
Telephone Number	:	985-200-4726
Fax Number	:	985-338-2902

Provider Business Practice Location Address
First Line	:	532 PARK AVE
Second Line	:
City	:	MANDEVILLE
State	:	LA
Zip	:	70448-4915
Country	:	US
Telephone Number	:	985-200-4726
Fax Number	:	985-338-2902

Authorized Official
Title or Position	:	NP/OWNER
Name	:	SANDRA ALMERICO
Credential	:	NP
Telephone Number	:	985-200-4726

Provider Enumeration Date	:	11/07/2022
Last Update Date	:	03/12/2026

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