Provider Demographics
NPI:1467007807
Name:THE HOSPITAL SERVICE DISTRICT OF WEST FELICIANA PARISH LOUISIANA
Entity Type:Organization
Organization Name:THE HOSPITAL SERVICE DISTRICT OF WEST FELICIANA PARISH LOUISIANA
Other - Org Name:ST. FRANCIS CYPRESS RURAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCCORD
Authorized Official - Suffix:IV
Authorized Official - Credentials:MHA
Authorized Official - Phone:225-635-2423
Mailing Address - Street 1:PO BOX 368
Mailing Address - Street 2:
Mailing Address - City:SAINT FRANCISVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70775-0368
Mailing Address - Country:US
Mailing Address - Phone:225-635-2441
Mailing Address - Fax:225-635-2442
Practice Address - Street 1:5266 COMMERCE ST BLDG A
Practice Address - Street 2:
Practice Address - City:SAINT FRANCISVILLE
Practice Address - State:LA
Practice Address - Zip Code:70775-4409
Practice Address - Country:US
Practice Address - Phone:225-635-2441
Practice Address - Fax:225-635-2442
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE HOSPITAL SERVICE DISTRICT OF WEST FELICIANA PARISH LOUISIANA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-02
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1734811Medicaid