Fleur De Lis Community Health Inc | |
376 Main St Cankton LA 70584-5920 | |
(337) 668-4141 | |
(337) 668-4386 |
Full Name | Fleur De Lis Community Health Inc |
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Speciality | Clinic/Center |
Location | 376 Main St, Cankton, Louisiana |
Authorized Official Name and Position | Angela B Neely (SECRETARY TREASURER) |
Authorized Official Contact | 3376684141 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Fleur De Lis Community Health Inc 376 Main St Cankton LA 70584-5920 Ph: (337) 668-4141 | Fleur De Lis Community Health Inc 376 Main St Cankton LA 70584-5920 Ph: (337) 668-4141 |
NPI Number | 1326032806 |
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Provider Enumeration Date | 09/09/2005 |
Last Update Date | 10/07/2014 |
Medicare PECOS PAC ID | 9638104458 |
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Medicare Enrollment ID | O20050930000002 |
Identifier | Type | State | Issuer |
---|---|---|---|
1326032806 | NPI | - | NPPES |
1447919 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QC1500X | Clinic/center - Community Health | PENDING (Louisiana) | Primary |
Provider Name | Angela Neely |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639163108 PECOS PAC ID: 1456386275 Enrollment ID: I20051003000001 |
Provider Name | Georgette Boudreaux Guillory |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518951086 PECOS PAC ID: 0547295362 Enrollment ID: I20051003000003 |
Provider Name | Michelle Claire Sonnier |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427350446 PECOS PAC ID: 4789855933 Enrollment ID: I20110919000660 |
Provider Name | Megan Deshotel Barousse |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033550686 PECOS PAC ID: 5395975478 Enrollment ID: I20140312000203 |
Fleur De Lis Family Healthcare Of Cankton Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 376 Main St, Cankton, LA 70584 Phone: 337-668-4141 Fax: 337-668-4386 |