Provider Demographics
NPI:1104850700
Name:UNITED MEDICAL HEALTHCARE INC
Entity Type:Organization
Organization Name:UNITED MEDICAL HEALTHCARE INC
Other - Org Name:UNITED MEDICAL REHABILITATION HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:STOCKWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-340-5998
Mailing Address - Street 1:15717 BELLE DR
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-1439
Mailing Address - Country:US
Mailing Address - Phone:985-340-5998
Mailing Address - Fax:985-340-0239
Practice Address - Street 1:15717 BELLE DR
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1439
Practice Address - Country:US
Practice Address - Phone:985-340-5998
Practice Address - Fax:985-340-0239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA587283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1700711Medicaid
LA190060646ZOtherBLUE CROSS
LA00112014OtherOFFICE OF GROUP BENEFITS