| St. Gabriel - Innovation | |
|
7800 Innovation Dr Baton Rouge LA 70820 | |
| (225) 642-9676 | |
| (225) 642-9696 |
| Full Name | St. Gabriel - Innovation |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 7800 Innovation Dr, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Marilyn Brown Antwine (COMPLIANCE OFFICER) |
| Authorized Official Contact | 2256429676 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Gabriel - Innovation Po Box 209 Saint Gabriel LA 70776-0209 Ph: (225) 642-9676 | St. Gabriel - Innovation 7800 Innovation Dr Baton Rouge LA 70820 Ph: (225) 642-9676 |
| NPI Number | 1013405646 |
|---|---|
| Provider Enumeration Date | 04/30/2018 |
| Last Update Date | 04/30/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013405646 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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