Provider Demographics
NPI:1649295015
Name:SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC
Entity type:Organization
Organization Name:SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON-HATCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-494-2094
Mailing Address - Street 1:1701 OAK PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-8911
Mailing Address - Country:US
Mailing Address - Phone:337-494-6444
Mailing Address - Fax:337-494-6451
Practice Address - Street 1:2010 OAK PARK BLVD
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8913
Practice Address - Country:US
Practice Address - Phone:337-494-6444
Practice Address - Fax:337-494-6451
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-13
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA197005Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER