Provider Demographics
NPI:1740617364
Name:OUR LADY OF THE ANGELS HOSPITAL, INC.
Entity Type:Organization
Organization Name:OUR LADY OF THE ANGELS HOSPITAL, INC.
Other - Org Name:OUR LADY OF THE ANGELS HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MARKET PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:BRYAN
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-730-6700
Mailing Address - Street 1:433 PLAZA ST
Mailing Address - Street 2:
Mailing Address - City:BOGALUSA
Mailing Address - State:LA
Mailing Address - Zip Code:70427-3729
Mailing Address - Country:US
Mailing Address - Phone:985-730-6700
Mailing Address - Fax:
Practice Address - Street 1:433 PLAZA ST
Practice Address - Street 2:
Practice Address - City:BOGALUSA
Practice Address - State:LA
Practice Address - Zip Code:70427-3729
Practice Address - Country:US
Practice Address - Phone:985-730-6700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-27
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA333600000X, 3336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy