| |
4422 General Meyer Ave 100 New Orleans LA 70131-3588 | |
(504) 364-4067 | |
(504) 364-4077 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 4422 General Meyer Ave, New Orleans, Louisiana |
Authorized Official Name and Position | Evangelin Franklin (CLINICAL DIRECTOR) |
Authorized Official Contact | 5046582512 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4422 General Meyer Ave 100 New Orleans LA 70131-3588 Ph: (504) 364-4067 | 4422 General Meyer Ave 100 New Orleans LA 70131-3588 Ph: (504) 364-4067 |
NPI Number | 1790904555 |
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Provider Enumeration Date | 04/24/2007 |
Last Update Date | 07/24/2007 |
Identifier | Type | State | Issuer |
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1790904555 | NPI | - | NPPES |
1941191 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 261QP0400X (Louisiana) | Primary |
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