Teche Action Clinic | |
827 N Pine St Gramercy LA 70052-3602 | |
(337) 828-2550 | |
(337) 355-2333 |
Full Name | Teche Action Clinic |
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Speciality | Clinic/Center |
Location | 827 N Pine St, Gramercy, Louisiana |
Authorized Official Name and Position | Gary M Wiltz (CEO) |
Authorized Official Contact | 3378282550 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Teche Action Clinic 1115 Weber St. Franklin LA 70538-4124 Ph: (337) 828-2550 | Teche Action Clinic 827 N Pine St Gramercy LA 70052-3602 Ph: (337) 828-2550 |
NPI Number | 1801433883 |
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Provider Enumeration Date | 12/09/2019 |
Last Update Date | 07/12/2023 |
Medicare PECOS PAC ID | 0648163980 |
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Medicare Enrollment ID | O20230413000056 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801433883 | NPI | - | NPPES |
5B803 | Other | LA | MEDICARE PART B |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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