St Gabriel Health Clinic Inc | |
5760 Monticello Dr Saint Gabriel LA 70776-4412 | |
(225) 642-9676 | |
(225) 642-9696 |
Full Name | St Gabriel Health Clinic Inc |
---|---|
Speciality | Family Medicine |
Location | 5760 Monticello Dr, Saint Gabriel, 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 |
---|---|
St Gabriel Health Clinic Inc Po Box 209 Saint Gabriel LA 70776-0209 Ph: (225) 642-9676 | St Gabriel Health Clinic Inc 5760 Monticello Dr Saint Gabriel LA 70776-4412 Ph: (225) 642-9676 |
NPI Number | 1093874000 |
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Provider Enumeration Date | 12/06/2006 |
Last Update Date | 05/02/2025 |
Medicare PECOS PAC ID | 9830008416 |
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Medicare Enrollment ID | O20101123000739 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093874000 | NPI | - | NPPES |
2422430 | Medicaid | LA | |
2503341 | Medicaid | LA | |
2156161 | Medicaid | LA | |
1093874000 | Other | NPI | |
1944114 | Medicaid | LA | |
1457680 | Medicaid | LA | |
2191217 | Medicaid | LA | |
2503146 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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