| Ejchc | |
|
11312 Jefferson Hwy River Ridge LA 70123-1709 | |
| (504) 464-0032 | |
| (504) 466-3440 |
| Full Name | Ejchc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 11312 Jefferson Hwy, River Ridge, Louisiana |
| Authorized Official Name and Position | Patricia Ann Bowman (CO-CHAIR) |
| Authorized Official Contact | 5044640032 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ejchc 11312 Jefferson Hwy River Ridge LA 70123-1709 Ph: (504) 464-0032 | Ejchc 11312 Jefferson Hwy River Ridge LA 70123-1709 Ph: (504) 464-0032 |
| NPI Number | 1174664510 |
|---|---|
| Provider Enumeration Date | 02/09/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174664510 | NPI | - | NPPES |
| 1947652 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 80-001271 (Louisiana) | Primary |
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