Provider Demographics
NPI:1922584523
Name:ST. THOMAS COMMUNITY HEALTH CENTER, INC
Entity Type:Organization
Organization Name:ST. THOMAS COMMUNITY HEALTH CENTER, INC
Other - Org Name:ST. THOMAS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:T
Authorized Official - Last Name:ERWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-529-5558
Mailing Address - Street 1:1936 MAGAZINE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-5016
Mailing Address - Country:US
Mailing Address - Phone:504-529-5558
Mailing Address - Fax:
Practice Address - Street 1:1024 JACKSON AVE STE A
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-5546
Practice Address - Country:US
Practice Address - Phone:504-529-5558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. THOMAS COMMUNITY HEALTH CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-17
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPHY.007737-IR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAPHY.007737-IROtherLOUISIANA STATE BOARD OF PHARMACY