Provider Demographics
NPI:1205856226
Name:HOSPITAL SERVICE DISTRICT NO. 1 OF PLAQUEMINES PARISH
Entity Type:Organization
Organization Name:HOSPITAL SERVICE DISTRICT NO. 1 OF PLAQUEMINES PARISH
Other - Org Name:PLAQUEMINES MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:PREST
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:504-564-3344
Mailing Address - Street 1:27136 HIGHWAY 23
Mailing Address - Street 2:
Mailing Address - City:PORT SULPHUR
Mailing Address - State:LA
Mailing Address - Zip Code:70083-2648
Mailing Address - Country:US
Mailing Address - Phone:504-564-3344
Mailing Address - Fax:504-564-0174
Practice Address - Street 1:27136 HIGHWAY 23
Practice Address - Street 2:
Practice Address - City:PORT SULPHUR
Practice Address - State:LA
Practice Address - Zip Code:70083-2648
Practice Address - Country:US
Practice Address - Phone:504-564-3344
Practice Address - Fax:504-564-0174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1942804Medicaid
LA57508Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER