Provider Demographics
NPI:1093933897
Name:NATCHITOCHES PARISH HOSPITAL SERVICE DISTRICT
Entity Type:Organization
Organization Name:NATCHITOCHES PARISH HOSPITAL SERVICE DISTRICT
Other - Org Name:NORTH NATCHITOCHES MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C F O
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:MCCORMICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-214-4350
Mailing Address - Street 1:PO BOX 2475
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-2475
Mailing Address - Country:US
Mailing Address - Phone:318-663-6131
Mailing Address - Fax:
Practice Address - Street 1:3194 HWY 71
Practice Address - Street 2:
Practice Address - City:CAMPTI
Practice Address - State:LA
Practice Address - Zip Code:71411
Practice Address - Country:US
Practice Address - Phone:318-214-4200
Practice Address - Fax:318-214-4493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1808067Medicaid
LA1808067Medicaid