| Bph Enterprises, Llc | |
|
402 N Vaughan St Brusly LA 70719-2225 | |
| (225) 749-2645 | |
| (225) 749-8216 |
| Full Name | Bph Enterprises, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 402 N Vaughan St, Brusly, Louisiana |
| Authorized Official Name and Position | Brian P Higgins (PRESIDENT) |
| Authorized Official Contact | 2257492645 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bph Enterprises, Llc 402 N Vaughan St Brusly LA 70719-2225 Ph: (225) 749-2645 | Bph Enterprises, Llc 402 N Vaughan St Brusly LA 70719-2225 Ph: (225) 749-2645 |
| NPI Number | 1043316631 |
|---|---|
| Provider Enumeration Date | 09/15/2006 |
| Last Update Date | 07/16/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043316631 | NPI | - | NPPES |
| 1446777 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 024237 (Louisiana) | Primary |
Innis Community Health Center, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 630 North Vaughn Drive, Brusly, LA 70719 Phone: 225-492-3775 |