Provider Demographics
NPI:1740248129
Name:TERREBONNE PARISH HOSPITAL SERVICE DISTRICT #1
Entity type:Organization
Organization Name:TERREBONNE PARISH HOSPITAL SERVICE DISTRICT #1
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:D
Authorized Official - Last Name:YEATES
Authorized Official - Suffix:
Authorized Official - Credentials:CPA MBA
Authorized Official - Phone:985-873-4664
Mailing Address - Street 1:PO BOX 6037
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70361-6037
Mailing Address - Country:US
Mailing Address - Phone:985-873-4235
Mailing Address - Fax:985-851-4307
Practice Address - Street 1:8166 MAIN STREET
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360
Practice Address - Country:US
Practice Address - Phone:985-873-4141
Practice Address - Fax:985-851-4307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA13064OtherBLUE CROSS BLUE SHIELD
LA1943843Medicaid
5D037OtherMEDICARE PROF
LA1795887Medicaid
LA13064OtherBLUE CROSS BLUE SHIELD