| Dchc - the Net Charter High School: East | |
|
12000 Hayne Blvd New Orleans LA 70128-1127 | |
| (504) 267-3882 | |
| Not Available |
| Full Name | Dchc - the Net Charter High School: East |
|---|---|
| Speciality | Clinic/Center |
| Location | 12000 Hayne Blvd, New Orleans, Louisiana |
| Authorized Official Name and Position | Tanyelle Oatis-gaskew (LEAD CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5042129546 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dchc - the Net Charter High School: East Po Box 13038 New Orleans LA 70185-3038 Ph: (504) 207-3060 | Dchc - the Net Charter High School: East 12000 Hayne Blvd New Orleans LA 70128-1127 Ph: (504) 267-3882 |
| NPI Number | 1003675919 |
|---|---|
| Provider Enumeration Date | 03/14/2024 |
| Last Update Date | 03/14/2024 |
| Certification Date | 03/14/2024 |
| Medicare PECOS PAC ID | 3678755535 |
|---|---|
| Medicare Enrollment ID | O20250110001450 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003675919 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | () | Primary |
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