Teche Action Clinic @ Edgard | |
159 E 3rd St Edgard LA 70049-2450 | |
(985) 497-8726 | |
(985) 497-3108 |
Full Name | Teche Action Clinic @ Edgard |
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Speciality | Clinic/Center |
Location | 159 E 3rd St, Edgard, Louisiana |
Authorized Official Name and Position | Gary M Wiltz (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 3378282550 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Teche Action Clinic @ Edgard 1115 Weber Street Franklin LA 70538-4124 Ph: (337) 828-2550 | Teche Action Clinic @ Edgard 159 E 3rd St Edgard LA 70049-2450 Ph: (985) 497-8726 |
NPI Number | 1154368553 |
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Provider Enumeration Date | 06/02/2006 |
Last Update Date | 07/12/2023 |
Medicare PECOS PAC ID | 0648163980 |
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Medicare Enrollment ID | O20101122000722 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154368553 | NPI | - | NPPES |
5B803 | Other | LA | PART B |
2134434 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Teche Action Clinic @ West St. John Elementary Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2555 La Hwy 18, Edgard, LA 70049 Phone: 337-828-2550 Fax: 337-355-2335 |