Pacer Health Management Corporation

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

534 Issued in LA

Legal business name

PACER HEALTH MANAGEMENT CORPORATION

Doing business as

South Cameron Rural Health Clinic

Practice address

10080 Gulf Highway
Lake Charles, LA 70607-8672

Phone

(337) 905-4111

Fax

(337) 905-5711

NPI assigned

Feb 8, 2007

Organization subpart

Yes

Parent organization

PACER HEALTH MANAGEMENT CORPORATIONAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ray L. Shoemaker

Title

Ceo/Owner

Phone

(662) 321-1155

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• SOUTH CAMERON RURAL HEALTH CLINIC Doing business as

Part of

Pacer Health Management Corporation

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Pacer Health Management Corporation

  dba South Cameron Memorial Physicians

  • Rural Health Clinic/Center
  • Cameron, LA
  • NPI 1508997313
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270684800000",
    "number": "1497896153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5360 W. CREOLE HWY",
            "city": "CAMERON",
            "state": "LA",
            "postal_code": "706315127",
            "telephone_number": "337-542-4111",
            "fax_number": "337-542-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10080 GULF HIGHWAY",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706078672",
            "telephone_number": "337-905-4111",
            "fax_number": "337-905-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACER HEALTH MANAGEMENT CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PACER HEALTH MANAGEMENT CORPORATION",
        "enumeration_date": "2007-02-08",
        "last_updated": "2010-04-08",
        "status": "A",
        "authorized_official_last_name": "SHOEMAKER",
        "authorized_official_first_name": "RAY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "662-321-1155"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "LA",
            "license": "534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "H1471",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1944335",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS RHC",
            "identifier": "H1471",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH CAMERON RURAL HEALTH CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Rural Health Clinic/Center in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Rural Health Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.