Provider Demographics
NPI:1750820098
Name:ST TAMMANY PARISH DISTRICT HOSPITAL 2
Entity Type:Organization
Organization Name:ST TAMMANY PARISH DISTRICT HOSPITAL 2
Other - Org Name:SLIDELL MEMORIAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-280-2755
Mailing Address - Street 1:1045 FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2923
Mailing Address - Country:US
Mailing Address - Phone:985-280-2755
Mailing Address - Fax:985-280-1585
Practice Address - Street 1:1045 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2923
Practice Address - Country:US
Practice Address - Phone:985-280-2755
Practice Address - Fax:985-280-1585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA03469R261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA03469ROtherLOUISIANA PHYSICAL THERAPY BOARD