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508 Broadway St Delhi LA 71232-3002 | |
(318) 878-3737 | |
(318) 878-8638 |
Full Name | |
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Speciality | Clinic/Center |
Location | 508 Broadway St, Delhi, Louisiana |
Authorized Official Name and Position | Mildred Jinger 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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508 Broadway St Delhi LA 71232-3002 Ph: (318) 878-3737 | 508 Broadway St Delhi LA 71232-3002 Ph: (318) 878-3737 |
NPI Number | 1174586283 |
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Provider Enumeration Date | 04/10/2006 |
Last Update Date | 01/12/2024 |
Medicare PECOS PAC ID | 1456307230 |
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Medicare Enrollment ID | O20071126000690 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174586283 | NPI | - | NPPES |
1946001 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | 119RHC-1 (Louisiana) | Primary |
Vicksburg Clinic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 508 Broadway, Delhi, LA 71232 Phone: 318-878-3737 | |