Provider Demographics
NPI:1568404838
Name:RAPIDES PRIMARY HEALTH CARE CENTER, INCORPORATED
Entity Type:Organization
Organization Name:RAPIDES PRIMARY HEALTH CARE CENTER, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-487-4400
Mailing Address - Street 1:1217 WILLOW GLEN RIVER RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71302-5454
Mailing Address - Country:US
Mailing Address - Phone:318-487-4400
Mailing Address - Fax:318-487-0525
Practice Address - Street 1:1217 WILLOW GLEN RIVER RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71302-5454
Practice Address - Country:US
Practice Address - Phone:318-487-4400
Practice Address - Fax:318-487-0525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1443751Medicaid
LA1443751Medicaid