Provider Demographics
NPI:1851317911
Name:HOSPITAL SERVICE DISTRICT NO 1-A OF THE PARISH OF RICHLAND STATE OF LA
Entity Type:Organization
Organization Name:HOSPITAL SERVICE DISTRICT NO 1-A OF THE PARISH OF RICHLAND STATE OF LA
Other - Org Name:RICHLAND PARISH HOSPITAL BASED PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MILDRED
Authorized Official - Middle Name:JINGER
Authorized Official - Last Name:GREER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-878-6398
Mailing Address - Street 1:407 CINCINNATI ST
Mailing Address - Street 2:
Mailing Address - City:DELHI
Mailing Address - State:LA
Mailing Address - Zip Code:71232-3007
Mailing Address - Country:US
Mailing Address - Phone:318-878-5171
Mailing Address - Fax:318-878-8638
Practice Address - Street 1:407 CINCINNATI ST
Practice Address - Street 2:
Practice Address - City:DELHI
Practice Address - State:LA
Practice Address - Zip Code:71232
Practice Address - Country:US
Practice Address - Phone:318-878-5171
Practice Address - Fax:318-878-8638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207PE0004X, 207Q00000X, 207R00000X
LA149261QC0050X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QC0050XAmbulatory Health Care FacilitiesClinic/CenterCritical Access Hospital
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA190004826ZOtherBLUE CROSS
LA1755290Medicaid