Provider Demographics
NPI:1679065478
Name:HOSPITAL SERVICE DISTRICT 1 OF EAST BATON ROUGE PARISH DBA LANE REGION
Entity Type:Organization
Organization Name:HOSPITAL SERVICE DISTRICT 1 OF EAST BATON ROUGE PARISH DBA LANE REGION
Other - Org Name:LANE WORKFORCE WELLNESS/WELLNESS WORKS
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-658-4303
Mailing Address - Street 1:6300 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791
Mailing Address - Country:US
Mailing Address - Phone:225-658-4000
Mailing Address - Fax:225-658-4586
Practice Address - Street 1:6300 MAIN STREET
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791
Practice Address - Country:US
Practice Address - Phone:225-658-4000
Practice Address - Fax:225-658-4586
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LANE WORKFORCE WELLNESS/WELLNESS WORKS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-06
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
90020OtherBLUE CROSS BLUE SHIELD OF LA