TECHE ACTION BOARD INC (NPI# 1124307566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124307566 |
| Entity Type | Organization |
| Organization Name | TECHE ACTION BOARD INC |
| Other Organization Name | TECHE ACTION CLINIC @ MORGAN CITY |
| Practice Address |
1124 7th St Morgan City LA 70380-1951 |
| Mailing Address |
1115 Weber St Franklin LA 70538-4124 |
| Practice Telephone | 9853842371 |
| Practice Fax Number | 9853842645 |
| Mailing Telephone | 3378282550 |
| Mailing Fax Number | 3373552335 |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2014-03-12 |
| Authorized Official Name | MR. GARY M WILTZ (CEO) |
| Authorized Official Telephone | 3378282550 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | TECHE ACTION BOARD INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
LA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2195417 | 05 | |
| LA | MEDICARE PART B | 5B803 | 01 |
| Other Name | Type Code |
|---|---|
| Teche Action Clinic @ Morgan City | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972746964 | Teche Action Board Inc | Clinic/Center | 3528 Highway 70 S, Pierre Part, LA 70339-4452 | 2009-04-07 |
| 1386880433 | Teche Action Board Inc | Clinic/Center | 473 Central Ave, Reserve, LA 70084-5509 | 2008-12-19 |
| 1679726459 | Teche Action Board Inc | Pharmacy | 1014 W Tunnel Blvd, Houma, LA 70360-4050 | 2008-10-24 |
| 1174579262 | Teche Action Board Inc | Clinic/Center | 1115 Weber St, Franklin, LA 70538-4124 | 2006-05-26 |
| Street Address |
1124 7TH ST |
| City | MORGAN CITY |
| State | LA |
| Zip Code | 70380-1951 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720070824 | Russo Clinic-a Medical Corporation | Internal Medicine | 1124 7th St, Morgan City, LA 70380-1951 | 2005-08-16 |
| 1760016562 | Teche Action Board, Inc. | Pharmacist | 1124 7th St, Morgan City, LA 70380 | 2020-03-02 |
| 1639702087 | Teche Action Board, Inc. | Pharmacy | 1124 7th St, Morgan City, LA 70380-1951 | 2020-02-13 |
| 1740732536 | Bethanie Taylor Thibodaux | Nurse Practitioner | 1124 7th St, Morgan City, LA 70380 | 2016-10-27 |
| 1396121117 | Teche Action Board, Inc. | Clinic/Center | 1124 7th St, Morgan City, LA 70380-1951 | 2015-08-04 |
| 1669814513 | Kristi Mcdonald Boudreaux | Nurse Practitioner | 1124 7th St, Morgan City, LA 70380-1951 | 2013-07-20 |
| 1134493695 | Kalisha Antonia Nelson | Dentist | 1124 7th St, Morgan City, LA 70380-1951 | 2012-03-01 |
| 1417235953 | St Mary Pharmacy LLC | Pharmacy | 1124 7th St, Morgan City, LA 70380-1951 | 2011-08-02 |
| 1649569906 | Nsikan St Martin | Obstetrics & Gynecology | 1124 7th St, Morgan City, LA 70380-1951 | 2011-04-06 |
| 1376737973 | Russos Health Mart Inc | Durable Medical Equipment & Medical Supplies | 1124 7th St, Morgan City, LA 70380-1951 | 2007-08-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720625486 | Aubree Elizabeth-grace Underwood | Counselor | Fairview Treatment Center, 1101 Southeast Blvd, Morgan City, LA 70380 | 2019-12-02 |
| 1235609827 | Lori Billiot | Counselor | 434 Lagonda Rd, Morgan City, LA 70380 | 2018-11-27 |
| 1942720255 | Landon Robinson | Non-emergency Medical Transport (VAN) | 1200 Victor II Blvd Suite 500, Morgan City, LA 70380 | 2017-06-27 |
| 1588198212 | Marcia Ann Blereau | Nurse Practitioner | 1122 8th St, Morgan City, LA 70380 | 2017-04-19 |
| 1316312119 | Daniel Lebeouf | Pharmacist | 1002 La-70, Morgan City, LA 70380 | 2015-12-04 |
| 1154667210 | Bayou Smiles Center | Dentist | 1205 Victor II Blvd, Morgan City, LA 70380 | 2012-12-18 |
| 1265788707 | Hpc Biologicals Inc | Pharmacy | 1234 David Dr Ste A, Morgan City, LA 70380 | 2012-08-02 |
| 1376824102 | Don Monroe Ryan | Pharmacist | 1301 Highway 90 East, Morgan City, LA 70380 | 2011-09-07 |
| 1235449067 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 1216 Victor II Blvd, Ste 300, Morgan City, LA 70380 | 2010-10-14 |
| 1659600989 | Walter H. Daniels, M.d. A Professional Medical Corp. | Family Medicine | 1300 Lakewood Drive, Suite G, Morgan City, LA 70380 | 2009-12-16 |
| Find all providers in zip 70380 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1013522879 | Marillac Community Health Centers | Clinic/Center | 1423 Saint Philip St, New Orleans, LA 70116-2933 | 2020-09-09 |
| 1669086690 | Marillac Community Health Centers | Clinic/Center | 1908 Short St, Kenner, LA 70062-7550 | 2020-09-08 |
| 1023629425 | Winn Community Health Center, Inc. | Clinic/Center | 2200 N Bolton Ave, Alexandria, LA 71303-4407 | 2020-08-11 |
| 1467061515 | Council for Advancement of Social Service and Education | Clinic/Center | 1560 Irving Place, Shreveport, LA 71101-4604 | 2020-07-24 |
| Find all providers with the same taxonomy | ||||
| City | MORGAN CITY |
| Zip Code | 70380 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.