Provider Demographics
NPI:1366029779
Name:CONCORDIA PARISH HOSPITAL SERVICE DISTRICT NUMBER ONE
Entity Type:Organization
Organization Name:CONCORDIA PARISH HOSPITAL SERVICE DISTRICT NUMBER ONE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:VIGIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-757-6551
Mailing Address - Street 1:PO BOX 111
Mailing Address - Street 2:
Mailing Address - City:FERRIDAY
Mailing Address - State:LA
Mailing Address - Zip Code:71334-0111
Mailing Address - Country:US
Mailing Address - Phone:318-757-6551
Mailing Address - Fax:
Practice Address - Street 1:6569 HWY 84
Practice Address - Street 2:
Practice Address - City:FERRIDAY
Practice Address - State:LA
Practice Address - Zip Code:71334
Practice Address - Country:US
Practice Address - Phone:318-757-6551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONCORDIA PARISH HOSPITAL SERVICE DISTRICT NUMBER ONE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health