| Baton Rouge Charter Academy At Mid City Satellite Clinic | |
|
1900 Lobdell Blvd Baton Rouge LA 70806-1725 | |
| (225) 810-3125 | |
| (225) 642-9696 |
| Full Name | Baton Rouge Charter Academy At Mid City Satellite Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1900 Lobdell Blvd, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Marilyn B Antwine (COO) |
| Authorized Official Contact | 2256429676 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Baton Rouge Charter Academy At Mid City Satellite Clinic Po Box 209 Saint Gabriel LA 70776-0209 Ph: (225) 642-9676 | Baton Rouge Charter Academy At Mid City Satellite Clinic 1900 Lobdell Blvd Baton Rouge LA 70806-1725 Ph: (225) 810-3125 |
| NPI Number | 1760858302 |
|---|---|
| Provider Enumeration Date | 08/18/2015 |
| Last Update Date | 08/18/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760858302 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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