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St Gabriel Health Clinic Inc

St Gabriel Health Clinic Inc is a health care provider in Saint Gabriel, LA. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 5760 Monticello Drive, St Gabriel, LA 70776, US
Practice Location Phone225-642-9676
Practice Location Fax225-642-9696
Legal Business NameST GABRIEL HEALTH CLINIC INC
NPI ?1093874000
Entity TypeOrganization
Enumeration Date ? Dec 6, 2006
Last Update Date ? Jun 16, 2015
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of St Gabriel Health Clinic Inc

SpecialtySpecializationLicenseLicense State
Family Medicine

legacy-id-icon Legacy Provider IDs of St Gabriel Health Clinic Inc

Provider IdIssuer StateIssuer TypeIssuer
1944114LouisianaMedicaid
1457680LouisianaMedicaid
2156161LouisianaMedicaid
2191217LouisianaMedicaid
1457701LouisianaMedicaid

official-icon Authorized Official of St Gabriel Health Clinic Inc

An authorized official is an appointed official with the legal authority to make changes and/or updates to the St Gabriel Health Clinic Inc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Mrs. Marilyn B Antwine
Authorized Official Title/PositionCOO
Authorized Official Phone Number225-642-9676