| Phsc-grambling Family Health Center | |
|
7604 Hwy 80 Grambling LA 71245 | |
| (318) 388-1250 | |
| Not Available |
| Full Name | Phsc-grambling Family Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 7604 Hwy 80, Grambling, Louisiana |
| Authorized Official Name and Position | Catherine M. Tonore (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3183881250 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phsc-grambling Family Health Center 7604 Hwy 80 Grambling LA 71245 Ph: (318) 388-1250 | Phsc-grambling Family Health Center 7604 Hwy 80 Grambling LA 71245 Ph: (318) 388-1250 |
| NPI Number | 1659827996 |
|---|---|
| Provider Enumeration Date | 08/28/2016 |
| Last Update Date | 04/15/2021 |
| Medicare PECOS PAC ID | 2062300858 |
|---|---|
| Medicare Enrollment ID | O20170619002637 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659827996 | NPI | - | NPPES |
| 2437984 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Grambling State University Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 403 Main St, Grambling, LA 71245 Phone: 318-274-2351 |