MEDICARE: ACCESS HEALTH LOUISIANA

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	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1437708237
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCESS HEALTH LOUISIANA

Provider Business Mailing Address
First Line	:	2900 INDIANA AVE
Second Line	:
City	:	KENNER
State	:	LA
Zip	:	70065-4605
Country	:	US
Telephone Number	:	504-575-3712
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 BARONNE ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70113-1302
Country	:	US
Telephone Number	:	866-530-6111
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MARK KEISER
Credential	:
Telephone Number	:	504-575-3700

Provider Enumeration Date	:	09/05/2019
Last Update Date	:	09/05/2019

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Directions to “ACCESS HEALTH LOUISIANA ” Practice Location

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