| Mabel Brasher Elementary School | |
|
601 Cloverleaf Blvd Alexandria LA 71303-3808 | |
| (318) 442-0878 | |
| Not Available |
| Full Name | Mabel Brasher Elementary School |
|---|---|
| Speciality | Clinic/Center |
| Location | 601 Cloverleaf Blvd, Alexandria, Louisiana |
| Authorized Official Name and Position | Deano Thornton (CEO) |
| Authorized Official Contact | 3186480375 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mabel Brasher Elementary School Po Box 1288 Winnfield LA 71483-1288 Ph: (318) 209-4510 | Mabel Brasher Elementary School 601 Cloverleaf Blvd Alexandria LA 71303-3808 Ph: (318) 442-0878 |
| NPI Number | 1558925339 |
|---|---|
| Provider Enumeration Date | 04/26/2019 |
| Last Update Date | 07/20/2022 |
| Medicare PECOS PAC ID | 2567516545 |
|---|---|
| Medicare Enrollment ID | O20210513000779 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558925339 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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