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Organization

EXCELTH, INCORPORATED

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL A. ANDRY (CEO)
(504) 524-1210
Entity
Organization

Contact information

Practice address
730 COLONIAL DR STE E, BATON ROUGE, LA 70806-6536
(225) 201-0751
(225) 706-0173
Mailing address
1515 POYDRAS ST, SUITE 1070, NEW ORLEANS, LA 70112-3723
(504) 524-1210
(504) 524-1491

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1441589
LA
05
1944581
LA
Enumeration date
06/26/2006
Last updated
01/22/2024
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