| Marillac Community Health Centers | |
|
407 S Gould Ave Gould AR 71643-5041 | |
| (870) 382-3080 | |
| (870) 263-4782 |
| Full Name | Marillac Community Health Centers |
|---|---|
| Speciality | Clinic/Center |
| Location | 407 S Gould Ave, Gould, Arkansas |
| Authorized Official Name and Position | Tanyelle Oatis-gaskew (LEAD CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5042129546 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marillac Community Health Centers Po Box 13038 New Orleans LA 70185-3038 Ph: (504) 212-9546 | Marillac Community Health Centers 407 S Gould Ave Gould AR 71643-5041 Ph: (870) 382-3080 |
| NPI Number | 1982381752 |
|---|---|
| Provider Enumeration Date | 07/03/2023 |
| Last Update Date | 07/03/2023 |
| Medicare PECOS PAC ID | 3678755535 |
|---|---|
| Medicare Enrollment ID | O20240321002032 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982381752 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Ascension Depaul Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 407 S Gould Ave, Gould, AR 71643 Phone: 870-263-4317 | |
Depaul Community Health Centers - Gould Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 407 South Gould Ave, Gould, AR 71643 Phone: 870-263-4317 Fax: 870-263-4782 |