| Grant Sbhc | |
|
17763 Highway 167 Dry Prong LA 71423-9205 | |
| (318) 899-5276 | |
| (318) 899-5932 |
| Full Name | Grant Sbhc |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 17763 Highway 167, Dry Prong, Louisiana |
| Authorized Official Name and Position | Monte Wilson (CEO) |
| Authorized Official Contact | 3374702100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grant Sbhc 3330 Masonic Dr Alexandria LA 71301-3841 Ph: (318) 483-4031 | Grant Sbhc 17763 Highway 167 Dry Prong LA 71423-9205 Ph: (318) 899-5276 |
| NPI Number | 1750400586 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 10/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750400586 | NPI | - | NPPES |
| 1446971 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | 234 (Louisiana) | Primary |
Dry Prong Family Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 800 Grove Street, Dry Prong, LA 71423 Phone: 318-568-8298 Fax: 318-568-8297 | |
Access Health Louisiana Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 17763 Highway 167, Dry Prong, LA 71423 Phone: 866-530-6111 | |
Winn Community Health Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 21239 Highway 167, Dry Prong, LA 71423 Phone: 318-648-0375 |