Provider Demographics
NPI:1881321131
Name:SAVOY MEDICAL MANAGEMENT GROUP, INC
Entity type:Organization
Organization Name:SAVOY MEDICAL MANAGEMENT GROUP, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ARMENTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-468-0350
Mailing Address - Street 1:801 POINCIANA AVE
Mailing Address - Street 2:
Mailing Address - City:MAMOU
Mailing Address - State:LA
Mailing Address - Zip Code:70554-2298
Mailing Address - Country:US
Mailing Address - Phone:337-639-2067
Mailing Address - Fax:
Practice Address - Street 1:616 COURT ST.
Practice Address - Street 2:
Practice Address - City:OBERLIN
Practice Address - State:LA
Practice Address - Zip Code:70655
Practice Address - Country:US
Practice Address - Phone:337-468-0427
Practice Address - Fax:337-468-3342
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAVOY MEDICAL MANAGEMENT GROUP, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-05
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1766062Medicaid