| Basile Rural Health Clinic | |
|
1431 Fuselier Ave Basile LA 70515-5583 | |
| (337) 432-0200 | |
| (337) 432-0202 |
| Full Name | Basile Rural Health Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1431 Fuselier Ave, Basile, Louisiana |
| Authorized Official Name and Position | Michael W. Johnson (PRESIDENT) |
| Authorized Official Contact | 3374680355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Basile Rural Health Clinic 801 Poinciana Ave Mamou LA 70554-2243 Ph: (337) 432-0200 | Basile Rural Health Clinic 1431 Fuselier Ave Basile LA 70515-5583 Ph: (337) 432-0200 |
| NPI Number | 1609234012 |
|---|---|
| Provider Enumeration Date | 02/01/2016 |
| Last Update Date | 08/08/2022 |
| Medicare PECOS PAC ID | 1557403953 |
|---|---|
| Medicare Enrollment ID | O20160719002467 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609234012 | NPI | - | NPPES |
| 2455478 | Medicaid | LA | |
| 193924 | Other | LA | MEDICARE RHC CCN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 2203783121 (Louisiana) | Primary |
| Provider Name | Tara Baquet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982042024 PECOS PAC ID: 7416182878 Enrollment ID: I20131021001456 |
Basile Family Healthcare Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2932 Stagg Ave, Basile, LA 70515 Phone: 337-432-5552 Fax: 337-432-5553 | |
Basile Family Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2932 Stagg Ave, Ste A, Basile, LA 70515 Phone: 337-432-5552 Fax: 337-432-5553 | |
Basile Family Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2932 Stagg Ave, Suite A, Basile, LA 70515 Phone: 337-432-5552 Fax: 337-432-5553 |