Provider Demographics
NPI:1255300414
Name:ABBEVILLE GENERAL HOSPITAL
Entity Type:Organization
Organization Name:ABBEVILLE GENERAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF RURAL HEALTH CLINICS
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:T
Authorized Official - Last Name:HAIR
Authorized Official - Suffix:
Authorized Official - Credentials:AO
Authorized Official - Phone:337-898-6204
Mailing Address - Street 1:118 N HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70510-4039
Mailing Address - Country:US
Mailing Address - Phone:337-893-5466
Mailing Address - Fax:337-893-2801
Practice Address - Street 1:118 N HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510-4039
Practice Address - Country:US
Practice Address - Phone:337-893-5466
Practice Address - Fax:337-893-2801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA160282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA60785OtherBCBS ACUTE #
LA1733741Medicaid
LA=========OtherTIN #
LA190034Medicare Oscar/Certification