Provider Demographics
NPI:1740330976
Name:LARRISON FAMILY HEALTH CENTER, LLC
Entity type:Organization
Organization Name:LARRISON FAMILY HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERLYN
Authorized Official - Middle Name:BELL
Authorized Official - Last Name:LARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-252-6211
Mailing Address - Street 1:PO BOX 640
Mailing Address - Street 2:
Mailing Address - City:PIERRE PART
Mailing Address - State:LA
Mailing Address - Zip Code:70339-0640
Mailing Address - Country:US
Mailing Address - Phone:985-252-6211
Mailing Address - Fax:985-252-0006
Practice Address - Street 1:3617 HIGHWAY 70 S
Practice Address - Street 2:
Practice Address - City:PIERRE PART
Practice Address - State:LA
Practice Address - Zip Code:70339-4455
Practice Address - Country:US
Practice Address - Phone:985-252-6211
Practice Address - Fax:985-252-0006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA019912261QP2300X
LA019913261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1695122Medicaid
LA1441015Medicaid
LA1695131Medicaid
LA5H583Medicare ID - Type UnspecifiedSHERLYN B LARRISON INDIVI
LAG28980Medicare UPIN
LA5C756Medicare ID - Type UnspecifiedGROUP NUMBER
LA1695131Medicaid
LA1695122Medicaid