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11990 Jackson Street Clinton LA 70722-3210 | |
(225) 683-5292 | |
(225) 683-3411 |
Full Name | |
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Speciality | Clinic/Center |
Location | 11990 Jackson Street, Clinton, Louisiana |
Authorized Official Name and Position | Ginger A Hunt (CEO) |
Authorized Official Contact | 2256835292 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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P.o. Box 395 Clinton LA 70722-0395 Ph: (225) 683-5292 | 11990 Jackson Street Clinton LA 70722-3210 Ph: (225) 683-5292 |
NPI Number | 1699878645 |
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Provider Enumeration Date | 09/06/2006 |
Last Update Date | 01/28/2021 |
Medicare PECOS PAC ID | 1052220985 |
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Medicare Enrollment ID | O20060209000284 |
Identifier | Type | State | Issuer |
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1699878645 | NPI | - | NPPES |
1450278 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
East Feliciana Parish School Board Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12732 Silliman Street, Clinton, LA 70722 Phone: 225-683-8277 | |
Just Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11312 Spring St, Clinton, LA 70722 Phone: 833-784-2669 Fax: 844-784-2329 | |
Just Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11315 Bank St, Clinton, LA 70722 Phone: 225-683-8572 | |