Provider Demographics
NPI:1073649083
Name:BATON ROUGE GENERAL MEDICAL CENTER
Entity Type:Organization
Organization Name:BATON ROUGE GENERAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR VP AND CFO
Authorized Official - Prefix:
Authorized Official - First Name:DIONNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:VIATOR
Authorized Official - Suffix:
Authorized Official - Credentials:CPA, FACHE
Authorized Official - Phone:225-763-1540
Mailing Address - Street 1:3600 FLORIDA BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-3842
Mailing Address - Country:US
Mailing Address - Phone:225-387-7000
Mailing Address - Fax:225-381-6129
Practice Address - Street 1:3600 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-3842
Practice Address - Country:US
Practice Address - Phone:225-387-7000
Practice Address - Fax:225-381-6129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA284314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1720020Medicaid
ALBRG 0065NMedicaid
NC1900065Medicaid
OH2594830Medicaid
LA90065OtherBLUE CROSS
AZ371609Medicaid
LHVI10OtherUNITED HEALTHCARE
LHVI10OtherUNITED HEALTHCARE
=========OtherHUMANA
NC1900065Medicaid
ALBRG 0065NMedicaid
=========OtherCOVENTRY
195139Medicare ID - Type Unspecified