Provider Demographics
NPI:1497837330
Name:HOSPITAL SERVICE DISTRICT NO. 3
Entity Type:Organization
Organization Name:HOSPITAL SERVICE DISTRICT NO. 3
Other - Org Name:THIBODAUX REGIONAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:GAUBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-447-5500
Mailing Address - Street 1:PO BOX 1118
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70302-1118
Mailing Address - Country:US
Mailing Address - Phone:985-447-5500
Mailing Address - Fax:985-446-5033
Practice Address - Street 1:602 N ACADIA RD
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-4847
Practice Address - Country:US
Practice Address - Phone:985-447-5500
Practice Address - Fax:985-446-5033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA148283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY19T004Medicare Oscar/Certification