Provider Demographics
NPI:1134354202
Name:ST. CHARLES SURGICAL HOSPITAL, LLC
Entity type:Organization
Organization Name:ST. CHARLES SURGICAL HOSPITAL, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MYRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIGANGE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:504-899-2800
Mailing Address - Street 1:1717 SAINT CHARLES AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-5223
Mailing Address - Country:US
Mailing Address - Phone:504-899-2800
Mailing Address - Fax:504-899-2700
Practice Address - Street 1:1717 SAINT CHARLES AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-5223
Practice Address - Country:US
Practice Address - Phone:504-899-2800
Practice Address - Fax:504-899-2700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty