Provider Demographics
NPI:1356306971
Name:IASIS OUACHITA COMMUNITY HOSPITAL LP
Entity Type:Organization
Organization Name:IASIS OUACHITA COMMUNITY HOSPITAL LP
Other - Org Name:OUACHITA COMMUNITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-329-4200
Mailing Address - Street 1:117 SEABOARD LN BLDG E
Mailing Address - Street 2:ATTN: IASIS CORPORATE LEGAL DEPARTMENT
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2855
Mailing Address - Country:US
Mailing Address - Phone:615-844-2747
Mailing Address - Fax:615-467-1271
Practice Address - Street 1:1275 GLENWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-5539
Practice Address - Country:US
Practice Address - Phone:318-322-1339
Practice Address - Fax:318-322-1693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA633282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR167873105Medicaid
LA1703311Medicaid
LA61470OtherBCBS
190261Medicare Oscar/Certification