Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 907 Main St, Elton, Louisiana |
Authorized Official Name and Position | Johnny Williams (CFO) |
Authorized Official Contact | 3375842237 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
801 Poinciana Ave Mamou LA 70554-2243 Ph: (337) 584-2237 | 907 Main St Elton LA 70532-3228 Ph: (337) 584-2237 |
NPI Number | 1316984883 |
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Provider Enumeration Date | 06/01/2006 |
Last Update Date | 11/25/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316984883 | NPI | - | NPPES |
1947920 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Coushatta Tribe Of Louisiana Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2003 C C Bel Rd, Elton, LA 70532 Phone: 337-584-1439 Fax: 337-584-1473 | |