Organization
ACCESS HEALTH LOUISIANA
Active
Other names
St Charles Community Health Center, Destrehan
Organization subpart
No
Provider details
NPI number
Authorized official
TRENTON BUSSEY (CFO)
(985) 785-5800
Entity
Organization
Contact information
Practice address
843 MILLING AVE, LULING, LA 70070-4442
(985) 785-5800
(985) 785-5811
Mailing address
843 MILLING AVE, LULING, LA 70070-4442
(985) 785-5800
(985) 785-5811
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD04201R
LA
207RC0000X
Cardiovascular Disease Physician
MD.04201R
LA
207RN0300X
Nephrology Physician
MD.03945R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2156501
—
LA
Enumeration date
01/10/2011
Last updated
08/06/2012
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