Provider Demographics
NPI:1275193773
Name:MONROE SURGICAL HOSPITAL, LLC
Entity Type:Organization
Organization Name:MONROE SURGICAL HOSPITAL, LLC
Other - Org Name:THE MEDICAL OFFICE OF MANGHAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEMPHILL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:318-812-9500
Mailing Address - Street 1:PO BOX 51193
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-1193
Mailing Address - Country:US
Mailing Address - Phone:318-248-2807
Mailing Address - Fax:318-248-2967
Practice Address - Street 1:261 HIGHWAY 132
Practice Address - Street 2:
Practice Address - City:MANGHAM
Practice Address - State:LA
Practice Address - Zip Code:71259-5269
Practice Address - Country:US
Practice Address - Phone:318-248-2807
Practice Address - Fax:318-248-2967
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONROE SURGICAL HOSPITAL, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-17
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty