Provider Demographics
NPI:1114222072
Name:CALDWELL MEMORIAL HOSPITAL, INC
Entity Type:Organization
Organization Name:CALDWELL MEMORIAL HOSPITAL, INC
Other - Org Name:CHATHAM RURAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:W
Authorized Official - Last Name:ETHERIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-249-2743
Mailing Address - Street 1:PO BOX 899
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:LA
Mailing Address - Zip Code:71418-0899
Mailing Address - Country:US
Mailing Address - Phone:318-649-6111
Mailing Address - Fax:318-649-5094
Practice Address - Street 1:6619 HIGHWAY 34
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:LA
Practice Address - Zip Code:71226-9326
Practice Address - Country:US
Practice Address - Phone:318-249-2743
Practice Address - Fax:318-649-5094
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CALDWELL MEMORIAL HOSPITAL, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-24
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health