Provider Demographics
NPI:1477972255
Name:HUEY P.LONG MDICAL CENTER
Entity Type:Organization
Organization Name:HUEY P.LONG MDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBICHAUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-483-7337
Mailing Address - Street 1:2351 VANDENBURG DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-5609
Mailing Address - Country:US
Mailing Address - Phone:318-483-7337
Mailing Address - Fax:
Practice Address - Street 1:2351 VANDENBURG DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-5609
Practice Address - Country:US
Practice Address - Phone:318-483-7337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA255282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1900009OtherMEDICARE ID- TYPE UNSPECIFIED
LA1720381Medicaid