Provider Demographics
NPI:1508603168
Name:EAST CARROLL PARISH HOSPITAL
Entity type:Organization
Organization Name:EAST CARROLL PARISH HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LADONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGLERTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-559-4023
Mailing Address - Street 1:300 SCARBOROUGH ST
Mailing Address - Street 2:
Mailing Address - City:LAKE PROVIDENCE
Mailing Address - State:LA
Mailing Address - Zip Code:71254-3018
Mailing Address - Country:US
Mailing Address - Phone:318-559-4024
Mailing Address - Fax:318-231-5011
Practice Address - Street 1:300 SCARBOROUGH ST
Practice Address - Street 2:
Practice Address - City:LAKE PROVIDENCE
Practice Address - State:LA
Practice Address - Zip Code:71254-3018
Practice Address - Country:US
Practice Address - Phone:318-231-5010
Practice Address - Fax:318-231-5011
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EAST CARROLL PARISH HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-11
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)