Provider Demographics
NPI:1578938452
Name:HOSPITAL SERVICE DISTRICT NO 2 OF PARISH OF BEAUREGARD STATE OF LA
Entity Type:Organization
Organization Name:HOSPITAL SERVICE DISTRICT NO 2 OF PARISH OF BEAUREGARD STATE OF LA
Other - Org Name:BEAUREGARD FAMILY MEDICINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHARRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-462-7100
Mailing Address - Street 1:600 S PINE ST
Mailing Address - Street 2:
Mailing Address - City:DERIDDER
Mailing Address - State:LA
Mailing Address - Zip Code:70634-4942
Mailing Address - Country:US
Mailing Address - Phone:337-462-7100
Mailing Address - Fax:
Practice Address - Street 1:501 S PINE ST
Practice Address - Street 2:
Practice Address - City:DERIDDER
Practice Address - State:LA
Practice Address - Zip Code:70634-4939
Practice Address - Country:US
Practice Address - Phone:337-463-9890
Practice Address - Fax:337-462-9521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-03
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health