Provider Demographics
NPI:1336315449
Name:ASCENSION URGENT CARE, LLC
Entity Type:Organization
Organization Name:ASCENSION URGENT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:GLEN
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-313-3754
Mailing Address - Street 1:14350 HIGHWAY 73
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-3617
Mailing Address - Country:US
Mailing Address - Phone:225-248-6134
Mailing Address - Fax:225-313-6012
Practice Address - Street 1:14350 HIGHWAY 73
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-3617
Practice Address - Country:US
Practice Address - Phone:225-248-6134
Practice Address - Fax:225-313-6012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15167R261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAI15132Medicare UPIN
LA4F878DE56Medicare PIN
LA6164500001Medicare NSC