Provider Demographics
NPI:1801020433
Name:SLIDELL MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:SLIDELL MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:T
Authorized Official - Last Name:BADINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-280-8503
Mailing Address - Street 1:1001 GAUSE BLVD
Mailing Address - Street 2:BOX 75
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2939
Mailing Address - Country:US
Mailing Address - Phone:985-280-3609
Mailing Address - Fax:985-280-9651
Practice Address - Street 1:1001 GAUSE BLVD # 75
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458
Practice Address - Country:US
Practice Address - Phone:985-280-3609
Practice Address - Fax:985-280-9651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-11
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5DJ74Medicare PIN