Provider Demographics
NPI:1982627360
Name:VISTA SURGICAL HOSPITAL OF BATON ROUGE, LLC.
Entity Type:Organization
Organization Name:VISTA SURGICAL HOSPITAL OF BATON ROUGE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AVP, BUSINESS SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:WINCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-378-3000
Mailing Address - Street 1:PO BOX 5917
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77508-5917
Mailing Address - Country:US
Mailing Address - Phone:713-378-3000
Mailing Address - Fax:713-378-3104
Practice Address - Street 1:9032 PERKINS RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-1507
Practice Address - Country:US
Practice Address - Phone:713-378-3000
Practice Address - Fax:713-378-3104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA493282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1702323Medicaid
LA60565OtherBCBS #
LA1702323Medicaid