Provider Demographics
NPI:1306865761
Name:HOSPITAL SERVICE DISTRICT NO. 1 OF CALDWELL PARISH
Entity Type:Organization
Organization Name:HOSPITAL SERVICE DISTRICT NO. 1 OF CALDWELL PARISH
Other - Org Name:CITIZENS MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BARBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-649-6106
Mailing Address - Street 1:PO BOX 1079
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:LA
Mailing Address - Zip Code:71418-1079
Mailing Address - Country:US
Mailing Address - Phone:318-649-6106
Mailing Address - Fax:318-649-2080
Practice Address - Street 1:7939 HWY 165
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:LA
Practice Address - Zip Code:71418
Practice Address - Country:US
Practice Address - Phone:318-649-6106
Practice Address - Fax:318-649-2080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA188282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA57275OtherMEDICARE PROFESSIONAL
LA1796085Medicaid
LA1740764Medicaid
LA1740764Medicaid