| Jeffcare West Jefferson | |
|
5001 Westbank Expy Suite 100 Marrero LA 70072-2954 | |
| (504) 349-8833 | |
| (504) 838-5714 |
| Full Name | Jeffcare West Jefferson |
|---|---|
| Speciality | Clinic/Center |
| Location | 5001 Westbank Expy, Marrero, Louisiana |
| Authorized Official Name and Position | Rosanna Dichiro Derbes (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5048385215 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffcare West Jefferson 3616 S I 10 Service Rd W Ste 200 Metairie LA 70001-1874 Ph: (504) 838-5215 | Jeffcare West Jefferson 5001 Westbank Expy Suite 100 Marrero LA 70072-2954 Ph: (504) 349-8833 |
| NPI Number | 1154747327 |
|---|---|
| Provider Enumeration Date | 03/12/2014 |
| Last Update Date | 02/15/2022 |
| Certification Date | 02/15/2022 |
| Medicare PECOS PAC ID | 7911125513 |
|---|---|
| Medicare Enrollment ID | O20140822001842 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154747327 | NPI | - | NPPES |
| 2369393 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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