Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 106 Toombs St, Delhi, Louisiana |
Authorized Official Name and Position | Mildred J Greer (ADMINISTRATOR) |
Authorized Official Contact | 3188786398 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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407 Cincinnati St Delhi LA 71232-3007 Ph: (318) 878-8965 | 106 Toombs St Delhi LA 71232-2647 Ph: (318) 878-8965 |
NPI Number | 1083967178 |
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Provider Enumeration Date | 10/26/2012 |
Last Update Date | 01/12/2024 |
Medicare PECOS PAC ID | 1456307230 |
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Medicare Enrollment ID | O20130815000077 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083967178 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Vicksburg Clinic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 508 Broadway, Delhi, LA 71232 Phone: 318-878-3737 | |