| Life Coast Community Health Center Inc | |
|
1101 Audubon Ave Ste S1 Thibodaux LA 70301-4957 | |
| (985) 492-6170 | |
| Not Available |
| Full Name | Life Coast Community Health Center Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1101 Audubon Ave Ste S1, Thibodaux, Louisiana |
| Authorized Official Name and Position | Diane Webre (CLINIC MANAGER) |
| Authorized Official Contact | 9854926170 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Coast Community Health Center Inc 1101 Audubon Ave Ste S1 Thibodaux LA 70301-4957 Ph: (985) 492-6170 | Life Coast Community Health Center Inc 1101 Audubon Ave Ste S1 Thibodaux LA 70301-4957 Ph: (985) 492-6170 |
| NPI Number | 1073157970 |
|---|---|
| Provider Enumeration Date | 11/04/2019 |
| Last Update Date | 12/09/2022 |
| Medicare PECOS PAC ID | 3870929193 |
|---|---|
| Medicare Enrollment ID | O20200205001617 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073157970 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Thomas J Falterman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770532236 PECOS PAC ID: 0547204331 Enrollment ID: I20050613001008 |
| Provider Name | Elena L Mann |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750571105 PECOS PAC ID: 2163596909 Enrollment ID: I20080729000021 |
| Provider Name | Andrew Z. Williams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255479903 PECOS PAC ID: 3375601750 Enrollment ID: I20081029000598 |
| Provider Name | Darrel P Prestenbach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902118920 PECOS PAC ID: 8426182296 Enrollment ID: I20100816000385 |
| Provider Name | Laura E Mutter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801001227 PECOS PAC ID: 1052408879 Enrollment ID: I20110317000939 |
| Provider Name | Babiswarup R Chandamuri |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1104140144 PECOS PAC ID: 2163671876 Enrollment ID: I20121012000067 |
| Provider Name | Sheena G Duplantis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205155298 PECOS PAC ID: 1557588928 Enrollment ID: I20140807001923 |
| Provider Name | Conar P Fitton |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1316182744 PECOS PAC ID: 2264626936 Enrollment ID: I20161010001360 |
| Provider Name | Maria F Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427508522 PECOS PAC ID: 9830478411 Enrollment ID: I20161206001872 |
| Provider Name | Mariam H Menhem |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1194161901 PECOS PAC ID: 3173819174 Enrollment ID: I20180828001483 |
| Provider Name | Amanda G Lucas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871079822 PECOS PAC ID: 9739433509 Enrollment ID: I20181114000260 |
| Provider Name | James B Hyatt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891878427 PECOS PAC ID: 4486797818 Enrollment ID: I20190924001195 |
| Provider Name | David Desonier |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1871694331 PECOS PAC ID: 6103246442 Enrollment ID: I20201026002014 |
| Provider Name | Brittany G James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104590843 PECOS PAC ID: 0446658264 Enrollment ID: I20211008001914 |
| Provider Name | Heather M Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235808544 PECOS PAC ID: 2769860188 Enrollment ID: I20220525002513 |
| Provider Name | Ian T Watson |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1689134900 PECOS PAC ID: 6800122128 Enrollment ID: I20230906001839 |
| Provider Name | Seth Haydel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871122739 PECOS PAC ID: 1456770247 Enrollment ID: I20231018001110 |
| Provider Name | Scott P Bellanger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083383970 PECOS PAC ID: 8729430434 Enrollment ID: I20240118001799 |
| Provider Name | George J Andrews |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720109028 PECOS PAC ID: 8022450048 Enrollment ID: I20240522002468 |
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