MEDICARE: ROSEMORE GARNER JR. MHS

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	171M00000X	Case Manager/Care Coordinator		LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649725730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSEMORE GARNER JR. MHS

Provider Business Mailing Address
First Line	:	6201 SUMMERLIN DR
Second Line	:
City	:	ZACHARY
State	:	LA
Zip	:	70791-2672
Country	:	US
Telephone Number	:	225-444-6144
Fax Number	:

Provider Business Practice Location Address
First Line	:	6201 SUMMERLIN DR
Second Line	:
City	:	ZACHARY
State	:	LA
Zip	:	70791-2672
Country	:	US
Telephone Number	:	225-315-9905
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2016
Last Update Date	:	01/16/2026

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