| St Gabriel Health Clinic Inc | |
|
1707 Gardere Ln Ste E Baton Rouge LA 70820-8144 | |
| (225) 642-9676 | |
| (225) 642-9696 |
| Full Name | St Gabriel Health Clinic Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1707 Gardere Ln Ste E, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Shirley F Wade (CEO) |
| Authorized Official Contact | 2256429676 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Gabriel Health Clinic Inc 5760 Monticello Dr Saint Gabriel LA 70776-4412 Ph: (225) 642-9676 | St Gabriel Health Clinic Inc 1707 Gardere Ln Ste E Baton Rouge LA 70820-8144 Ph: (225) 642-9676 |
| NPI Number | 1962777136 |
|---|---|
| Provider Enumeration Date | 03/20/2012 |
| Last Update Date | 10/26/2022 |
| Medicare PECOS PAC ID | 9830008416 |
|---|---|
| Medicare Enrollment ID | O20150808015705 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962777136 | NPI | - | NPPES |
| 2191217 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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