MEDICARE: PRIMARY CARE PROVIDERS FOR A HEALTHY FELICIANA INC

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)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467608729
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMARY CARE PROVIDERS FOR A HEALTHY FELICIANA INC

Provider Business Mailing Address
First Line	:	P.O. BOX 395
Second Line	:
City	:	CLINTON
State	:	LA
Zip	:	70722-0395
Country	:	US
Telephone Number	:	225-683-1370
Fax Number	:	225-683-1379

Provider Business Practice Location Address
First Line	:	3166 CHURCH ST
Second Line	:
City	:	SLAUGHTER
State	:	LA
Zip	:	70777
Country	:	US
Telephone Number	:	225-683-1370
Fax Number	:	225-658-6500

Authorized Official
Title or Position	:	CEO
Name	:	GINGER A HUNT
Credential	:	FPNP-C
Telephone Number	:	225-683-5292

Provider Enumeration Date	:	08/18/2008
Last Update Date	:	04/08/2022

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