Provider Demographics
NPI:1144244831
Name:ST. TAMMANY PARISH HOSPITAL SERVICE DISTRICT NO 1
Entity Type:Organization
Organization Name:ST. TAMMANY PARISH HOSPITAL SERVICE DISTRICT NO 1
Other - Org Name:ST. TAMMANY HOSPITAL HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-898-4000
Mailing Address - Street 1:101 ASHLAND WAY STE 2
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70447-3357
Mailing Address - Country:US
Mailing Address - Phone:985-871-5976
Mailing Address - Fax:985-871-5977
Practice Address - Street 1:101 ASHLAND WAY STE 2
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:LA
Practice Address - Zip Code:70447-3357
Practice Address - Country:US
Practice Address - Phone:985-871-5976
Practice Address - Fax:985-898-5977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community BasedGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1580333Medicaid
LA33722OtherHOSPICE OF ST TAMMANY HOS
LA6290620OtherHOSPICE OF ST TAMMANY HOS
LA1580333Medicaid