Provider Demographics
NPI:1073836078
Name:PROGRESSIVE ACUTE CARE AVOYELLES, LLC
Entity Type:Organization
Organization Name:PROGRESSIVE ACUTE CARE AVOYELLES, LLC
Other - Org Name:AVOYELLES HOSPITAL PHYSICIAN PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP BUSINESS SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:VARNADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-624-7401
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:
Mailing Address - City:MARKSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71351-0249
Mailing Address - Country:US
Mailing Address - Phone:318-253-5600
Mailing Address - Fax:318-253-0000
Practice Address - Street 1:4239 HIGHWAY 1192 STE 100
Practice Address - Street 2:
Practice Address - City:MARKSVILLE
Practice Address - State:LA
Practice Address - Zip Code:71351-4772
Practice Address - Country:US
Practice Address - Phone:318-253-5600
Practice Address - Fax:318-253-0000
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROGRESSIVE ACUTE CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA424282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital