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2801 General De Gaulle Drive Suite A New Orleans LA 70114-3204 | |
(504) 362-8930 | |
(504) 368-8486 |
Full Name | |
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Speciality | Clinic/Center |
Location | 2801 General De Gaulle Drive, New Orleans, Louisiana |
Authorized Official Name and Position | Michael Griffin (PRESIDENT/CEO) |
Authorized Official Contact | 5042073060 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 13038 New Orleans LA 70185-3038 Ph: (504) 207-3060 | 2801 General De Gaulle Drive Suite A New Orleans LA 70114-3204 Ph: (504) 362-8930 |
NPI Number | 1093249518 |
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Provider Enumeration Date | 04/12/2017 |
Last Update Date | 09/23/2024 |
Medicare PECOS PAC ID | 3678755535 |
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Medicare Enrollment ID | O20170526000167 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093249518 | 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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