Provider Demographics
NPI:1689625345
Name:LAFOURCHE PARISH HOSPITAL SERVICE DISTRICT #2
Entity Type:Organization
Organization Name:LAFOURCHE PARISH HOSPITAL SERVICE DISTRICT #2
Other - Org Name:ST ANNE GENERAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:D
Authorized Official - Last Name:BOURGEOIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:985-537-8377
Mailing Address - Street 1:4608 HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:RACELAND
Mailing Address - State:LA
Mailing Address - Zip Code:70394-2623
Mailing Address - Country:US
Mailing Address - Phone:985-537-6841
Mailing Address - Fax:985-537-8273
Practice Address - Street 1:4608 HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:RACELAND
Practice Address - State:LA
Practice Address - Zip Code:70394-2623
Practice Address - Country:US
Practice Address - Phone:985-537-6841
Practice Address - Fax:985-537-8273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA225282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA04759OtherBLUE CROSS ER PHY
LA1734357Medicaid
LA1797430Medicaid
LAG2660OtherBLUE CROSS CRNA
LA90109OtherBLUE CROSS
LA19Z324Medicare ID - Type Unspecified
LA19S109Medicare ID - Type UnspecifiedMC PSYCH
LA19M324Medicare ID - Type Unspecified
LA57496Medicare ID - Type Unspecified
LA19U109Medicare ID - Type Unspecified
LA1734357Medicaid
LA1797430Medicaid
LA195165Medicare Oscar/Certification