Provider Demographics
NPI:1629516612
Name:SAVOY MEDICAL MANAGEMENT GROUP, INC
Entity Type:Organization
Organization Name:SAVOY MEDICAL MANAGEMENT GROUP, INC
Other - Org Name:VILLE PLATTE FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERIM CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-468-0350
Mailing Address - Street 1:1013 W. LINCOLN ROAD
Mailing Address - Street 2:
Mailing Address - City:VILLE PLATTE
Mailing Address - State:LA
Mailing Address - Zip Code:70586
Mailing Address - Country:US
Mailing Address - Phone:337-363-0075
Mailing Address - Fax:337-363-0491
Practice Address - Street 1:1013 W LINCOLN RD
Practice Address - Street 2:
Practice Address - City:VILLE PLATTE
Practice Address - State:LA
Practice Address - Zip Code:70586-3045
Practice Address - Country:US
Practice Address - Phone:337-458-0355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAVOY MEDICAL MANAGEMENT GROUP, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-09
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA193935OtherMEDICARE
LA2489232OtherMEDICAID