Provider Demographics
NPI:1376820936
Name:BOGALUSA HEALTH CARE INC
Entity Type:Organization
Organization Name:BOGALUSA HEALTH CARE INC
Other - Org Name:BOGALUSA HEALTH CARE INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VERNA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:504-488-0050
Mailing Address - Street 1:512 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BOGALUSA
Mailing Address - State:LA
Mailing Address - Zip Code:70427-4706
Mailing Address - Country:US
Mailing Address - Phone:985-732-0401
Mailing Address - Fax:985-732-0501
Practice Address - Street 1:512 E 6TH ST
Practice Address - Street 2:
Practice Address - City:BOGALUSA
Practice Address - State:LA
Practice Address - Zip Code:70427-4706
Practice Address - Country:US
Practice Address - Phone:985-732-0401
Practice Address - Fax:985-732-0501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174V00000XOther Service ProvidersClinical EthicistGroup - Multi-Specialty