Provider Demographics
NPI:1578568481
Name:SLIDELL MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:SLIDELL MEMORIAL HOSPITAL
Other - Org Name:ST TAMMANY PARISH HOSPITAL SERVICE DISTRICT #2
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:T
Authorized Official - Last Name:BADINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-280-2200
Mailing Address - Street 1:1001 GAUSE BLVD
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2987
Mailing Address - Country:US
Mailing Address - Phone:985-643-2200
Mailing Address - Fax:
Practice Address - Street 1:1001 GAUSE BLVD
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2939
Practice Address - Country:US
Practice Address - Phone:985-643-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-16
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA156282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1720313Medicaid
MS00020424Medicaid
LA1720313Medicaid