Provider Demographics
NPI:1831207547
Name:LOUISIANA MEDICAL CENTER AND HEART HOSPITAL, LLC
Entity type:Organization
Organization Name:LOUISIANA MEDICAL CENTER AND HEART HOSPITAL, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-690-7503
Mailing Address - Street 1:64030 LOUISIANA HIGHWAY 434
Mailing Address - Street 2:
Mailing Address - City:LACOMBE
Mailing Address - State:LA
Mailing Address - Zip Code:70445-3456
Mailing Address - Country:US
Mailing Address - Phone:985-690-7500
Mailing Address - Fax:985-690-7530
Practice Address - Street 1:64030 LOUISIANA HIGHWAY 434
Practice Address - Street 2:
Practice Address - City:LACOMBE
Practice Address - State:LA
Practice Address - Zip Code:70445-3456
Practice Address - Country:US
Practice Address - Phone:985-690-7500
Practice Address - Fax:985-690-7530
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARDIOVASCULAR CARE GROUP, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-25
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA494282N00000X
282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1702251Medicaid
LA60574OtherBCBS
LA60574OtherBC
LA60574OtherBC