Teche Action Clinic @ West St. John Elementary | |
2555 La Hwy 18 Edgard LA 70049-2417 | |
(337) 828-2550 | |
(337) 355-2335 |
Full Name | Teche Action Clinic @ West St. John Elementary |
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Speciality | Clinic/Center |
Location | 2555 La Hwy 18, Edgard, Louisiana |
Authorized Official Name and Position | Gary 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 |
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Teche Action Clinic @ West St. John Elementary 1115 Weber St Franklin LA 70538-4124 Ph: (337) 828-2550 | Teche Action Clinic @ West St. John Elementary 2555 La Hwy 18 Edgard LA 70049-2417 Ph: (337) 828-2550 |
NPI Number | 1912354176 |
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Provider Enumeration Date | 05/18/2016 |
Last Update Date | 07/12/2023 |
Medicare PECOS PAC ID | 0648163980 |
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Medicare Enrollment ID | O20161101000834 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912354176 | NPI | - | NPPES |
2426419 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Teche Action Clinic @ Edgard Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 159 E 3rd St, Edgard, LA 70049 Phone: 985-497-8726 Fax: 985-497-3108 |