Provider Demographics
NPI:1093719932
Name:CALCASIEU CAMERON HOSPITAL SERVICE DISTRICT
Entity Type:Organization
Organization Name:CALCASIEU CAMERON HOSPITAL SERVICE DISTRICT
Other - Org Name:WEST CALCASIEU CAMERON HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHEIF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-527-4143
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:337-527-4335
Practice Address - Street 1:701 CYPRESS ST
Practice Address - Street 2:
Practice Address - City:SULPHUR
Practice Address - State:LA
Practice Address - Zip Code:70663-5053
Practice Address - Country:US
Practice Address - Phone:337-527-7034
Practice Address - Fax:337-527-4335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-09
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA226282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA90013OtherBLUE CROSS PROVIDER NUMBE
LA1730483Medicaid
LA1730483Medicaid