Gardere Center For Primary Care | |
1707 Gardere Ln Ste E Baton Rouge LA 70820-8166 | |
(225) 930-4922 | |
(225) 930-4926 |
Full Name | Gardere Center For Primary Care |
---|---|
Speciality | Clinic/Center |
Location | 1707 Gardere Ln Ste E, Baton Rouge, Louisiana |
Authorized Official Name and Position | Ashley T Levy (CEO) |
Authorized Official Contact | 2256429676 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Gardere Center For Primary Care Po Box 209 Saint Gabriel LA 70776-0209 Ph: (225) 642-9676 | Gardere Center For Primary Care 1707 Gardere Ln Ste E Baton Rouge LA 70820-8166 Ph: (225) 930-4922 |
NPI Number | 1962777136 |
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Provider Enumeration Date | 03/20/2012 |
Last Update Date | 04/21/2025 |
Medicare PECOS PAC ID | 9830008416 |
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Medicare Enrollment ID | O20150808015705 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962777136 | NPI | - | NPPES |
2191217 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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