Provider Demographics
NPI:1043218365
Name:HOSPITAL SERVICE DISTRICT NO. 1 OF THE PARISH OF ST. MARY
Entity Type:Organization
Organization Name:HOSPITAL SERVICE DISTRICT NO. 1 OF THE PARISH OF ST. MARY
Other - Org Name:BAYOU BEND HEALTH SYSTEM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:GUIDRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-828-0760
Mailing Address - Street 1:PO BOX 577
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:LA
Mailing Address - Zip Code:70538-0577
Mailing Address - Country:US
Mailing Address - Phone:337-828-0760
Mailing Address - Fax:337-828-5024
Practice Address - Street 1:1097 NORTHWEST BLVD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:LA
Practice Address - Zip Code:70538-3407
Practice Address - Country:US
Practice Address - Phone:337-828-0760
Practice Address - Fax:337-828-5024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA627282NC0060X
LA123282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1720062Medicaid
191310Medicare Oscar/Certification