Alexandria Middle Magnet School-based Clinic | |
122 Maryland Ave Alexandria LA 71301-5403 | |
(318) 648-0375 | |
(318) 648-0378 |
Full Name | Alexandria Middle Magnet School-based Clinic |
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Speciality | Clinic/Center |
Location | 122 Maryland Ave, Alexandria, Louisiana |
Authorized Official Name and Position | Deano Thornton (CEO) |
Authorized Official Contact | 3182094510 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Alexandria Middle Magnet School-based Clinic Po Box 1288 Winnfield LA 71483-1288 Ph: (318) 209-4510 | Alexandria Middle Magnet School-based Clinic 122 Maryland Ave Alexandria LA 71301-5403 Ph: (318) 648-0375 |
NPI Number | 1396267068 |
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Provider Enumeration Date | 07/13/2017 |
Last Update Date | 06/26/2019 |
Medicare PECOS PAC ID | 2567516545 |
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Medicare Enrollment ID | O20210512001125 |
Identifier | Type | State | Issuer |
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1396267068 | NPI | - | NPPES |
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