Provider Demographics
NPI:1689676835
Name:NATCHITOCHES PARISH HOSPITAL SERVICE DISTRICT
Entity Type:Organization
Organization Name:NATCHITOCHES PARISH HOSPITAL SERVICE DISTRICT
Other - Org Name:NATCHITOCHES REGIONAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIMA
Authorized Official - Middle Name:B
Authorized Official - Last Name:MCCORMICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-214-4200
Mailing Address - Street 1:501 KEYSER AVE
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-6018
Mailing Address - Country:US
Mailing Address - Phone:318-214-4200
Mailing Address - Fax:318-214-4493
Practice Address - Street 1:501 KEYSER AVE
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-6018
Practice Address - Country:US
Practice Address - Phone:318-214-4200
Practice Address - Fax:318-214-4493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA208282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1720143Medicaid
LA90007OtherBLUE CROSS ACUTE
LA1720143Medicaid