Provider Demographics
NPI:1235510280
Name:EVANGELINE CLINICAL SERVICES, INC.
Entity Type:Organization
Organization Name:EVANGELINE CLINICAL SERVICES, INC.
Other - Org Name:SAVOY EMERGENCY ROOM PHYSICIAN GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP GROUP OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-561-7191
Mailing Address - Street 1:80 VERSAILLES BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3979
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:801 POINCIANA AVE
Practice Address - Street 2:
Practice Address - City:MAMOU
Practice Address - State:LA
Practice Address - Zip Code:70554-2243
Practice Address - Country:US
Practice Address - Phone:337-468-5261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty