Provider Demographics
NPI:1245300425
Name:ST. TAMMANY PARISH HOSPITAL SERVICE DISTRICT NO 1
Entity type:Organization
Organization Name:ST. TAMMANY PARISH HOSPITAL SERVICE DISTRICT NO 1
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-898-4410
Mailing Address - Street 1:1202 S. TYLER STREET
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-2330
Mailing Address - Country:US
Mailing Address - Phone:985-898-4000
Mailing Address - Fax:
Practice Address - Street 1:1202 S. TYLER STREET
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-2330
Practice Address - Country:US
Practice Address - Phone:985-898-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. TAMMANY PARISH HOSPITAL SERVICE DISTRICT NO 1
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-08
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA19T045Medicare Oscar/Certification
LA19T045Medicare Oscar/Certification
19T045Medicare Oscar/Certification