Healthcare Provider Details

I. General information

NPI: 1750293692
Provider Name (Legal Business Name): SOUTHWEST LOUISIANA PRIMARY HEALTH CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 S. BULLARD ST
OPELOUSAS LA
70570
US

IV. Provider business mailing address

8762 HIGHWAY 182
OPELOUSAS LA
70570-5603
US

V. Phone/Fax

Practice location:
  • Phone: 337-942-3390
  • Fax:
Mailing address:
  • Phone: 337-942-3390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: DODIE LAMOTT
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 337-942-3390