| Surrey Street Community Health Center #1 | |
|
1004 Surrey St Lafayette LA 70501-6143 | |
| (337) 456-6768 | |
| (337) 456-8690 |
| Full Name | Surrey Street Community Health Center #1 |
|---|---|
| Speciality | Clinic/Center |
| Location | 1004 Surrey St, Lafayette, Louisiana |
| Authorized Official Name and Position | Roderick Campbell (CEO) |
| Authorized Official Contact | 3373654945 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Surrey Street Community Health Center #1 1004 Surrey St Lafayette LA 70501-6143 Ph: (337) 456-6768 | Surrey Street Community Health Center #1 1004 Surrey St Lafayette LA 70501-6143 Ph: (337) 456-6768 |
| NPI Number | 1568731602 |
|---|---|
| Provider Enumeration Date | 12/19/2011 |
| Last Update Date | 01/31/2024 |
| Medicare PECOS PAC ID | 6204817828 |
|---|---|
| Medicare Enrollment ID | O20110324000573 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568731602 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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