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234 Loyola Ave Fl 3 New Orleans LA 70112-2026 | |
(985) 307-1600 | |
(504) 575-3691 |
Full Name | |
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Speciality | Clinic/Center |
Location | 234 Loyola Ave Fl 3, New Orleans, Louisiana |
Authorized Official Name and Position | Mark F Keiser (CEO) |
Authorized Official Contact | 5045753700 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2900 Indiana Ave Kenner LA 70065-4605 Ph: (504) 575-3712 | 234 Loyola Ave Fl 3 New Orleans LA 70112-2026 Ph: (985) 307-1600 |
NPI Number | 1316443716 |
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Provider Enumeration Date | 04/04/2018 |
Last Update Date | 04/04/2018 |
Medicare PECOS PAC ID | 3678484276 |
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Medicare Enrollment ID | O20180824000387 |
Identifier | Type | State | Issuer |
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1316443716 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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