MEDICARE: IBERIA COMPREHENSIVE COMMUNITY HEALTH CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0002X	Clinic Pharmacy

General Provider Information

NPI Number	:	1114495355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IBERIA COMPREHENSIVE COMMUNITY HEALTH CENTER

Provider Business Mailing Address
First Line	:	806 JEFFERSON TER
Second Line	:
City	:	NEW IBERIA
State	:	LA
Zip	:	70560-5727
Country	:	US
Telephone Number	:	337-365-4945
Fax Number	:

Provider Business Practice Location Address
First Line	:	1009 CHARITY STREET
Second Line	:
City	:	ABBEVILLE
State	:	LA
Zip	:	70510-5239
Country	:	US
Telephone Number	:	337-893-3443
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MONIQUE DUMOND
Credential	:
Telephone Number	:	337-365-4945

Provider Enumeration Date	:	11/06/2018
Last Update Date	:	12/01/2021

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Directions to “IBERIA COMPREHENSIVE COMMUNITY HEALTH CENTER ” Practice Location

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