Provider Demographics
NPI:1598193625
Name:ST. TAMMANY PARISH HOSPITAL SERVICE DISTRICT NO 1
Entity Type:Organization
Organization Name:ST. TAMMANY PARISH HOSPITAL SERVICE DISTRICT NO 1
Other - Org Name:BONE AND JOINT CLINIC AT ST. TAMMANY PARISH HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-898-4000
Mailing Address - Street 1:PO BOX 54482
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70154-4482
Mailing Address - Country:US
Mailing Address - Phone:985-893-9922
Mailing Address - Fax:985-892-3806
Practice Address - Street 1:71211 HIGHWAY 21
Practice Address - Street 2:SUITE A
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7121
Practice Address - Country:US
Practice Address - Phone:985-893-9922
Practice Address - Fax:985-892-3806
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. TAMMANY PARISH HOSPITAL SERVICE DISTRICT NO 1
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-29
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty