| Buckeye High Sbhc | |
|
715 Highway 1207 Deville LA 71328-8505 | |
| (866) 530-6111 | |
| Not Available |
| Full Name | Buckeye High Sbhc |
|---|---|
| Speciality | Clinic/Center |
| Location | 715 Highway 1207, Deville, 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 |
|---|---|
| Buckeye High Sbhc 2900 Indiana Ave Kenner LA 70065-4605 Ph: (504) 575-3712 | Buckeye High Sbhc 715 Highway 1207 Deville LA 71328-8505 Ph: (866) 530-6111 |
| NPI Number | 1003535121 |
|---|---|
| Provider Enumeration Date | 08/23/2022 |
| Last Update Date | 08/23/2022 |
| Certification Date | 08/23/2022 |
| Medicare PECOS PAC ID | 3678484276 |
|---|---|
| Medicare Enrollment ID | O20230828002123 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003535121 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | () | Primary |
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