Provider Demographics
NPI:1083751010
Name:HOSPITAL SERVICE DISTRICT 2 OF THE PARISH OF TANGIPAHOA STATE OF LA.
Entity Type:Organization
Organization Name:HOSPITAL SERVICE DISTRICT 2 OF THE PARISH OF TANGIPAHOA STATE OF LA.
Other - Org Name:HOOD MEMORIAL HOSPITAL -PHYSICIANS
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:DUGAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-284-2404
Mailing Address - Street 1:301 W. WALNUT ST.
Mailing Address - Street 2:
Mailing Address - City:AMITE
Mailing Address - State:LA
Mailing Address - Zip Code:70422-2025
Mailing Address - Country:US
Mailing Address - Phone:985-748-9485
Mailing Address - Fax:985-748-8144
Practice Address - Street 1:301 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:AMITE
Practice Address - State:LA
Practice Address - Zip Code:70422-2025
Practice Address - Country:US
Practice Address - Phone:985-748-7141
Practice Address - Fax:985-748-3181
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSPITAL SERVICE DISTRICT 2 OF THE PARISH OF TANGIPAHOA STATE OF LA.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-31
Last Update Date:2017-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA04772OtherBLUE CROSS PRO FEE
LA04772OtherBLUE CROSS
LA1797235Medicaid
LA04772OtherBLUE CROSS PRO FEE