Provider Demographics
NPI:1396520862
Name:LAKE SURGICAL HOSPITAL SLIDELL, LLC
Entity type:Organization
Organization Name:LAKE SURGICAL HOSPITAL SLIDELL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PISCIOTTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-641-0600
Mailing Address - Street 1:1700 LINDBERG DR
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-8062
Mailing Address - Country:US
Mailing Address - Phone:985-641-0600
Mailing Address - Fax:844-269-8002
Practice Address - Street 1:1810 LINDBERG DR STE 1400
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-8158
Practice Address - Country:US
Practice Address - Phone:985-641-0600
Practice Address - Fax:844-269-8002
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAKE SURGICAL HOSPITAL SLIDELL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-31
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital