| Tangipahoa Community Health Center | |
|
42351 Phyllis Ann Dr Hammond LA 70403-1254 | |
| (985) 956-7406 | |
| (504) 575-3691 |
| Full Name | Tangipahoa Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 42351 Phyllis Ann Dr, Hammond, 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 |
|---|---|
| Tangipahoa Community Health Center 2900 Indiana Ave Kenner LA 70065-4605 Ph: (504) 575-3712 | Tangipahoa Community Health Center 42351 Phyllis Ann Dr Hammond LA 70403-1254 Ph: (985) 956-7406 |
| NPI Number | 1790163715 |
|---|---|
| Provider Enumeration Date | 05/11/2015 |
| Last Update Date | 09/15/2016 |
| Medicare PECOS PAC ID | 3678484276 |
|---|---|
| Medicare Enrollment ID | O20151002002277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790163715 | NPI | - | NPPES |
| 2396099 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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