| Jefferson Community Health Care Centers Inc | |
|
4028 Highway 90 W Avondale LA 70094-2622 | |
| (504) 436-2223 | |
| (504) 436-2224 |
| Full Name | Jefferson Community Health Care Centers Inc |
|---|---|
| Speciality | General Practice |
| Location | 4028 Highway 90 W, Avondale, Louisiana |
| Authorized Official Name and Position | Stacey Marie Lovell (BILLING OFFICE/CREDENTIALING) |
| Authorized Official Contact | 5044362223 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson Community Health Care Centers Inc 4028 Highway 90 W Avondale LA 70094-2622 Ph: (504) 436-2223 | Jefferson Community Health Care Centers Inc 4028 Highway 90 W Avondale LA 70094-2622 Ph: (504) 436-2223 |
| NPI Number | 1124000773 |
|---|---|
| Provider Enumeration Date | 11/18/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124000773 | NPI | - | NPPES |
| 1447196 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
Access Health Louisiana Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 178 Millie Dr, Avondale, LA 70094 Phone: 866-530-6111 | |
Jefferson Community Health Care Centers, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3932 Highway 90 W, Avondale, LA 70094 Phone: 504-436-2223 Fax: 504-436-2224 |