Provider Demographics
NPI:1295757326
Name:ST. THOMAS COMMUNITY HEALTH CENTER, INC
Entity type:Organization
Organization Name:ST. THOMAS COMMUNITY HEALTH CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:T
Authorized Official - Last Name:ERWIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-529-5558
Mailing Address - Street 1:1020 SAINT ANDREW ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-5022
Mailing Address - Country:US
Mailing Address - Phone:504-529-5558
Mailing Address - Fax:504-525-3235
Practice Address - Street 1:1020 SAINT ANDREW ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-5022
Practice Address - Country:US
Practice Address - Phone:504-529-5558
Practice Address - Fax:504-529-8840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
152W00000X, 261QF0400X
LA207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1342921Medicaid
LA191868Medicare Oscar/Certification
LA5CX13Medicare PIN