| Teche Health @ Thibodaux | |
|
1709 Ridgefield Rd Thibodaux LA 70301-4333 | |
| (337) 828-2550 | |
| (337) 355-2335 |
| Full Name | Teche Health @ Thibodaux |
|---|---|
| Speciality | Clinic/Center |
| Location | 1709 Ridgefield Rd, Thibodaux, Louisiana |
| Authorized Official Name and Position | Gary M Wiltz (CEO) |
| Authorized Official Contact | 3378282550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Teche Health @ Thibodaux 1115 Weber St Franklin LA 70538-4124 Ph: (337) 828-2550 | Teche Health @ Thibodaux 1709 Ridgefield Rd Thibodaux LA 70301-4333 Ph: (337) 828-2550 |
| NPI Number | 1356767420 |
|---|---|
| Provider Enumeration Date | 03/12/2014 |
| Last Update Date | 08/11/2025 |
| Certification Date | 08/11/2025 |
| Medicare PECOS PAC ID | 0648163980 |
|---|---|
| Medicare Enrollment ID | O20140923000681 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356767420 | NPI | - | NPPES |
| 5B803 | Other | LA | MEDICARE PART B |
| 2381954 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | () | Primary |
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