MEDICARE: PRIMARY CARE SOLUTIONS L.L.C.

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1639319494
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMARY CARE SOLUTIONS L.L.C.

Provider Business Mailing Address
First Line	:	4056 OLD GENTILLY RD
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70126-4813
Country	:	US
Telephone Number	:	504-948-9810
Fax Number	:	504-948-9810

Provider Business Practice Location Address
First Line	:	4056 OLD GENTILLY RD
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70126-4813
Country	:	US
Telephone Number	:	504-948-9810
Fax Number	:	504-948-9810

Authorized Official
Title or Position	:	OWNER
Name	:	MS. TRACY HARRIS
Credential	:
Telephone Number	:	504-948-9810

Provider Enumeration Date	:	03/05/2009
Last Update Date	:	03/05/2009

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