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IBERIA COMPREHENSIVE COMMUNITY HEALTH CENTER INC. NPI 1821286899


NPI Information

NPI: 1821286899
Provider Name: IBERIA COMPREHENSIVE COMMUNITY HEALTH CENTER, INC.

Doing Business As: ST. MARTIN PARISH COMMUNITY HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 19D1076013

Address:
317 DERNIER STREET
ST. MARTINVILLE, LA
ZIP 70582
Phone: (337) 365-4945
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IBERIA COMPREHENSIVE COMMUNITY HEALTH CENTER, INC. is a federally qualified health center (fqhc) clinic center in St. Martinville, LA. IBERIA COMPREHENSIVE COMMUNITY HEALTH CENTER, INC. NPI is 1821286899. The provider is registered as an organization entity type.
The provider Is Doing Business As St. Martin Parish Community Health Center.

The provider's business location address is:

317 DERNIER STREET
ST. MARTINVILLE, LA
ZIP 70582
Phone: (337) 365-4945
Fax: (337) 367-3917

The provider's authorized official is Roderick Campbell .
The authorized official title is Ceo and has the following contact phone number (337) 365-4945.

The CLIA number assigned to this NPI record is 19D1076013 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/4/2007 and was last updated on 12/1/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11028088MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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