St Gabriel Health Clinic Inc | |
5760 Monticello Drive St Gabriel LA 70776 | |
(225) 642-9676 | |
(225) 642-9696 |
Full Name | St Gabriel Health Clinic Inc |
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Speciality | Family Medicine |
Location | 5760 Monticello Drive, St Gabriel, Louisiana |
Authorized Official Name and Position | Shirley F Wade (CEO) |
Authorized Official Contact | 2256429676 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
St Gabriel Health Clinic Inc Po Box 209 Saint Gabriel LA 70776-0209 Ph: (225) 642-9676 | St Gabriel Health Clinic Inc 5760 Monticello Drive St Gabriel LA 70776 Ph: (225) 642-9676 |
NPI Number | 1093874000 |
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Provider Enumeration Date | 12/06/2006 |
Last Update Date | 10/26/2022 |
Medicare PECOS PAC ID | 9830008416 |
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Medicare Enrollment ID | O20101123000739 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093874000 | NPI | - | NPPES |
1944114 | Medicaid | LA | |
2503146 | Medicaid | LA | |
2156161 | Medicaid | LA | |
2191217 | Medicaid | LA | |
2503341 | Medicaid | LA | |
2422430 | Medicaid | LA | |
1457680 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Iberville Elem School Base Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5760 Monticello Dr, St Gabriel, LA 70776 Phone: 225-642-9676 Fax: 225-642-9696 | |
Glen Oaks Middle School Primary Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5600 Monticello Dr, St Gabriel, LA 70776 Phone: 225-642-9676 Fax: 225-642-9696 |