Provider Demographics
NPI:1952836629
Name:HOSPITAL SERVICE DISTRICT NO 1 OF THE PARRISH OF JEFFERSON DAVIS LA
Entity Type:Organization
Organization Name:HOSPITAL SERVICE DISTRICT NO 1 OF THE PARRISH OF JEFFERSON DAVIS LA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:RICHERT
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:337-824-5094
Mailing Address - Street 1:1634 ELTON RD
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546-3614
Mailing Address - Country:US
Mailing Address - Phone:337-616-7030
Mailing Address - Fax:337-616-7034
Practice Address - Street 1:1634 ELTON RD
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-3614
Practice Address - Country:US
Practice Address - Phone:337-616-7030
Practice Address - Fax:337-616-7034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty