Provider Demographics
NPI:1275010712
Name:ALLEGIANCE HOSPITAL OF MANY,LLC
Entity Type:Organization
Organization Name:ALLEGIANCE HOSPITAL OF MANY,LLC
Other - Org Name:TOLEDO BEND EXPRESS CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROCK
Authorized Official - Middle Name:
Authorized Official - Last Name:BORDELON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-226-8202
Mailing Address - Street 1:240 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:MANY
Mailing Address - State:LA
Mailing Address - Zip Code:71449-3767
Mailing Address - Country:US
Mailing Address - Phone:318-256-5691
Mailing Address - Fax:318-256-7540
Practice Address - Street 1:12060 TEXAS HWY
Practice Address - Street 2:
Practice Address - City:MANY
Practice Address - State:LA
Practice Address - Zip Code:71449
Practice Address - Country:US
Practice Address - Phone:318-256-5691
Practice Address - Fax:318-256-7540
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLEGIANCE HOSPITAL OF MANY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-27
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty