Provider Demographics
NPI:1932696812
Name:CHECK POINT URGENT CARE
Entity Type:Organization
Organization Name:CHECK POINT URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIDGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-330-2339
Mailing Address - Street 1:1108 PARKVIEW DR STE A
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70563-2883
Mailing Address - Country:US
Mailing Address - Phone:373-608-8488
Mailing Address - Fax:337-608-8481
Practice Address - Street 1:1108 PARKVIEW DR STE A
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70563-2883
Practice Address - Country:US
Practice Address - Phone:337-608-8488
Practice Address - Fax:337-608-8481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-17
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD203025261QU0200X
261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2490915Medicaid