Provider Demographics
NPI:1003409335
Name:HOMER MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:HOMER MEMORIAL HOSPITAL
Other - Org Name:BUTLER-ABSHIRE MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF QUALITY AND INTEGRATION OFFIC
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:318-927-2024
Mailing Address - Street 1:620 E COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:LA
Mailing Address - Zip Code:71040-3202
Mailing Address - Country:US
Mailing Address - Phone:318-927-2024
Mailing Address - Fax:
Practice Address - Street 1:926 FRANCES DR
Practice Address - Street 2:
Practice Address - City:HAYNESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71038-6100
Practice Address - Country:US
Practice Address - Phone:318-624-0554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOMER MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-17
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health