Provider Demographics
NPI:1447412325
Name:FIRST MEDICAL CLINIC APMC
Entity type:Organization
Organization Name:FIRST MEDICAL CLINIC APMC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:B
Authorized Official - Last Name:ESTARIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-465-0800
Mailing Address - Street 1:3321 FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-3680
Mailing Address - Country:US
Mailing Address - Phone:504-465-0800
Mailing Address - Fax:504-461-8516
Practice Address - Street 1:3321 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-3680
Practice Address - Country:US
Practice Address - Phone:504-465-0800
Practice Address - Fax:504-461-8516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2022-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAB89660Medicare UPIN