1558419275 NPI number — JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC

Table of content: REBECCA PAIGE FRENCH CPHT (NPI 1043310022)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558419275 NPI number — JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558419275
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/03/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4028 U S HIGHWAY 90
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AVONDALE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70094
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-436-2223
Provider Business Mailing Address Fax Number:
504-436-2224

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3932 HIGHWAY 90 W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AVONDALE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70094-2648
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-436-2223
Provider Business Practice Location Address Fax Number:
504-436-2224
Provider Enumeration Date:
01/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
JESSIE SKINNER
Authorized Official First Name:
JOELLE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
BILLING SPECIALIST
Authorized Official Telephone Number:
504-437-8523

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1452793 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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