Provider Demographics
NPI:1750638391
Name:MINUTE MED CLINIC LLC
Entity Type:Organization
Organization Name:MINUTE MED CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CORMIER-MIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-534-4410
Mailing Address - Street 1:3619 AMBASSADOR CAFFERY PKWY
Mailing Address - Street 2:BLDG E
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-5132
Mailing Address - Country:US
Mailing Address - Phone:337-534-4410
Mailing Address - Fax:337-534-4426
Practice Address - Street 1:3621 AMBASSADOR CAFFERY PKWY STE 100
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-5132
Practice Address - Country:US
Practice Address - Phone:337-534-4410
Practice Address - Fax:337-534-4426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-14
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty