| Cardinal Community Services Llc | |
|
13702 Coursey Blvd. Bldg 6 Ste A 2 Baton Rouge LA 70817 | |
| (225) 421-1686 | |
| (225) 349-7392 |
| Full Name | Cardinal Community Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 13702 Coursey Blvd. Bldg 6 Ste A 2, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Eurica R Gaston (CEO) |
| Authorized Official Contact | 2254211686 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cardinal Community Services Llc Po Box 87108 Baton Rouge LA 70879-8108 Ph: (225) 421-1686 | Cardinal Community Services Llc 13702 Coursey Blvd. Bldg 6 Ste A 2 Baton Rouge LA 70817 Ph: (225) 421-1686 |
| NPI Number | 1235522962 |
|---|---|
| Provider Enumeration Date | 03/05/2015 |
| Last Update Date | 06/17/2015 |
| Medicare PECOS PAC ID | 0840518817 |
|---|---|
| Medicare Enrollment ID | O20150423001627 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235522962 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Louisiana) | Primary |
| Provider Name | Eurica R Gaston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497802946 PECOS PAC ID: 6608972294 Enrollment ID: I20070427000162 |
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