| Iberia Comprehensive Community Health Center, Inc | |
|
1002 12th St Lafayette LA 70501-6224 | |
| (375) 340-1073 | |
| (337) 534-0184 |
| Full Name | Iberia Comprehensive Community Health Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1002 12th St, Lafayette, Louisiana |
| Authorized Official Name and Position | Monique Dumond (CFO) |
| Authorized Official Contact | 3373654945 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Iberia Comprehensive Community Health Center, Inc 806 Jefferson Ter New Iberia LA 70560-5727 Ph: (337) 365-4945 | Iberia Comprehensive Community Health Center, Inc 1002 12th St Lafayette LA 70501-6224 Ph: (375) 340-1073 |
| NPI Number | 1316244338 |
|---|---|
| Provider Enumeration Date | 02/28/2011 |
| Last Update Date | 12/01/2021 |
| Medicare PECOS PAC ID | 6204817828 |
|---|---|
| Medicare Enrollment ID | O20121119000443 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316244338 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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