Provider Demographics
NPI:1417950106
Name:CHRISTUS HEALTH NORTHERN LOUISIANA
Entity Type:Organization
Organization Name:CHRISTUS HEALTH NORTHERN LOUISIANA
Other - Org Name:CHRISTUS SHREVEPORT-BOSSIER HEALTH SYSTEM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:STEEN
Authorized Official - Last Name:TRAWICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-681-5054
Mailing Address - Street 1:PO BOX 843577
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-3577
Mailing Address - Country:US
Mailing Address - Phone:800-756-7999
Mailing Address - Fax:469-282-1999
Practice Address - Street 1:1453 E BERT KOUNS INDUSTRIAL LOOP
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-6800
Practice Address - Country:US
Practice Address - Phone:318-681-4500
Practice Address - Fax:318-681-4177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA0893235OtherCIGNA 20 SPRINT
LA340009OtherVALUE OPTION -MEDICAID HM
OK100699130AMedicaid
LA1744379Medicaid
TXHH7000OtherBCBSTX
AR108511105Medicaid
LA0787749OtherAMERIGROUP
TX094645102Medicaid
LA094645102OtherSUPERIOR HEALTH
LA1410667Medicaid
LA90041OtherBLUE CROSS
KY01300144Medicaid
MO015787302Medicaid
TX0787749-01Medicaid
AL127SCH170OtherBCBSAL
LA190041OtherSTERLING OPTION 1
LA1744379Medicaid
TXHH7000OtherBCBSTX
LA57309Medicare ID - Type UnspecifiedBLACK LUNG
OK100699130AMedicaid