Provider Demographics
NPI:1639323595
Name:ST. CHARLES SURGICAL HOSPITAL, LLC
Entity Type:Organization
Organization Name:ST. CHARLES SURGICAL HOSPITAL, LLC
Other - Org Name:ST. CHARLES SURGICAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MYRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIGANGE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:504-529-6600
Mailing Address - Street 1:1717 ST. CHARLES AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-5223
Mailing Address - Country:US
Mailing Address - Phone:504-529-6600
Mailing Address - Fax:504-529-6672
Practice Address - Street 1:1717 ST. CHARLES AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-5223
Practice Address - Country:US
Practice Address - Phone:504-529-6600
Practice Address - Fax:504-529-6672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-05
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA648284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital