Provider Demographics
NPI:1083992382
Name:CALCASIEU CAMERON HOSPITAL SERVICE DISTRICT
Entity Type:Organization
Organization Name:CALCASIEU CAMERON HOSPITAL SERVICE DISTRICT
Other - Org Name:SULPHUR COMMUNITY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:HANKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-527-4241
Mailing Address - Street 1:701 CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:SULPHUR
Mailing Address - State:LA
Mailing Address - Zip Code:70663-5053
Mailing Address - Country:US
Mailing Address - Phone:337-527-7034
Mailing Address - Fax:337-527-7337
Practice Address - Street 1:301 S CITIES SERVICE HWY
Practice Address - Street 2:
Practice Address - City:SULPHUR
Practice Address - State:LA
Practice Address - Zip Code:70663-6405
Practice Address - Country:US
Practice Address - Phone:337-527-6416
Practice Address - Fax:337-527-4966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-03
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA190013Medicare Oscar/Certification