Provider Demographics
NPI:1639243967
Name:NATCHITOCHES PARISH HOSPITAL SERVICE DISTRICT
Entity Type:Organization
Organization Name:NATCHITOCHES PARISH HOSPITAL SERVICE DISTRICT
Other - Org Name:NATCHITOCHES IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BRADFORD
Authorized Official - Last Name:MCCORMICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-214-4350
Mailing Address - Street 1:PO BOX 2154
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-2154
Mailing Address - Country:US
Mailing Address - Phone:318-214-4650
Mailing Address - Fax:318-214-4651
Practice Address - Street 1:105 EAST FIFTH STREET
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-2154
Practice Address - Country:US
Practice Address - Phone:318-214-4650
Practice Address - Fax:318-214-4651
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATCHITOCHES PARISH HOSPITAL SERVICE DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-20
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1449016Medicaid
LA2013504940OtherBLUE CROSS NUMBER
LA=========0OtherBLUE CROSS NUMBER