| St Tammany Slidell Chc | |
|
113 Christian Ln Slidell LA 70458-1377 | |
| (866) 530-6111 | |
| Not Available |
| Full Name | St Tammany Slidell Chc |
|---|---|
| Speciality | Clinic/Center |
| Location | 113 Christian Ln, Slidell, Louisiana |
| Authorized Official Name and Position | Mark Keiser (CEO) |
| Authorized Official Contact | 5045753700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Tammany Slidell Chc 2900 Indiana Ave Kenner LA 70065-4605 Ph: (866) 530-6111 | St Tammany Slidell Chc 113 Christian Ln Slidell LA 70458-1377 Ph: (866) 530-6111 |
| NPI Number | 1376191304 |
|---|---|
| Provider Enumeration Date | 09/03/2019 |
| Last Update Date | 04/11/2022 |
| Medicare PECOS PAC ID | 3678484276 |
|---|---|
| Medicare Enrollment ID | O20200319002569 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376191304 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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