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CH06476C St Gabriel Health Clinic Inc (Active)
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Main Details
Name
St Gabriel Health Clinic Inc
Subdivision Name
East Iberville Math, Science and Arts Academy
Type
HRSA-Funded Health Center
Site ID
BPS-H80-010654
340B ID
CH06476C
Grant Number
H80CS00551
Additional Details
Current Program Status
Active
Registration Date
10/5/2022
Participating Start Date
1/1/2023
Participating Approval Date
10/5/2022
Last Recertification Date
3/10/2025
Contacts
Authorizing Official
St. Gabriel Health Clinic, Inc.
Ashley T Levy, CEO
(225) 642-9676 Ext: 119
Primary Contact
St. Gabriel Health Clinic, Inc.
Lyssa Morris, Administrative Liason
(225) 642-9676
Addresses
Street Address
1825 Highway 30
Saint Gabriel, LA 70776-5326
Billing Address
St Gabriel Health Clinic Inc
5760
Monticello dr
St Gabriel, LA 70776
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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