Provider Demographics
NPI:1285021519
Name:LAFOURCHE PARISH HOSPITAL SERVICE DISTRICT NO. 1
Entity Type:Organization
Organization Name:LAFOURCHE PARISH HOSPITAL SERVICE DISTRICT NO. 1
Other - Org Name:LADY OF THE SEA COMMUNITY PHARMACY #1
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-632-8286
Mailing Address - Street 1:144 W 134TH ST
Mailing Address - Street 2:
Mailing Address - City:CUT OFF
Mailing Address - State:LA
Mailing Address - Zip Code:70345-4155
Mailing Address - Country:US
Mailing Address - Phone:985-325-9750
Mailing Address - Fax:985-325-9751
Practice Address - Street 1:144 W 134TH ST
Practice Address - Street 2:
Practice Address - City:CUT OFF
Practice Address - State:LA
Practice Address - Zip Code:70345-4155
Practice Address - Country:US
Practice Address - Phone:985-325-9750
Practice Address - Fax:985-325-9751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA71053336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2150722OtherPK