| St Charles Community Health Center, Norco | |
|
16004 River Rd Norco LA 70079-2040 | |
| (985) 725-9330 | |
| (504) 575-3691 |
| Full Name | St Charles Community Health Center, Norco |
|---|---|
| Speciality | Clinic/Center |
| Location | 16004 River Rd, Norco, Louisiana |
| Authorized Official Name and Position | Mark Keiser (PRESIDENT) |
| Authorized Official Contact | 5045753700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Charles Community Health Center, Norco 2900 Indiana Ave Kenner LA 70065-4605 Ph: (504) 575-3712 | St Charles Community Health Center, Norco 16004 River Rd Norco LA 70079-2040 Ph: (985) 725-9330 |
| NPI Number | 1376784868 |
|---|---|
| Provider Enumeration Date | 03/13/2009 |
| Last Update Date | 08/19/2016 |
| Medicare PECOS PAC ID | 3678484276 |
|---|---|
| Medicare Enrollment ID | O20090507000361 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376784868 | NPI | - | NPPES |
| 1579483 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Premise Health Of Louisiana Medical Professional Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14902 River Rd, Norco, LA 70079 Phone: 985-764-4666 Fax: 985-764-4568 |