Provider Demographics
NPI:1760427561
Name:WOMAN'S HOSPITAL FOUNDATION
Entity Type:Organization
Organization Name:WOMAN'S HOSPITAL FOUNDATION
Other - Org Name:WOMAN'S HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:TERI
Authorized Official - Middle Name:G
Authorized Official - Last Name:FONTENOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-927-1300
Mailing Address - Street 1:7662 GOODWOOD BLVD
Mailing Address - Street 2:BUILDING B201, SUITE A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-7622
Mailing Address - Country:US
Mailing Address - Phone:225-924-8480
Mailing Address - Fax:225-924-8627
Practice Address - Street 1:7662 GOODWOOD BLVD
Practice Address - Street 2:BUILDING B201, SUITE A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-7622
Practice Address - Country:US
Practice Address - Phone:225-924-8480
Practice Address - Fax:225-924-8627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA40264Medicaid
LA33522OtherBLUE CROSS OF LA
LA40264Medicaid