Provider Demographics
NPI:1477620730
Name:ACADIA -ST LANDRY HOSPITAL
Entity Type:Organization
Organization Name:ACADIA -ST LANDRY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:F
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:SAVOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-684-5435
Mailing Address - Street 1:810 S BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:CHURCH POINT
Mailing Address - State:LA
Mailing Address - Zip Code:70525-4402
Mailing Address - Country:US
Mailing Address - Phone:337-684-5435
Mailing Address - Fax:337-684-1408
Practice Address - Street 1:810 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:CHURCH POINT
Practice Address - State:LA
Practice Address - Zip Code:70525-4402
Practice Address - Country:US
Practice Address - Phone:337-684-5435
Practice Address - Fax:337-684-1408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2083X0100X2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1416002Medicaid