Provider Demographics
NPI:1841544194
Name:FRANCISCAN MISSIONARIES OF OUR LADY HEALTH SYSTEM INC
Entity type:Organization
Organization Name:FRANCISCAN MISSIONARIES OF OUR LADY HEALTH SYSTEM INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EVP, CHIEF PHYSICIAN OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAVEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-765-8724
Mailing Address - Street 1:1014 WEST ST. CLAIRE
Mailing Address - Street 2:STE 1010
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-5023
Mailing Address - Country:US
Mailing Address - Phone:225-437-2362
Mailing Address - Fax:225-743-2363
Practice Address - Street 1:1014 WEST ST. CLAIRE
Practice Address - Street 2:STE 1010
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-5023
Practice Address - Country:US
Practice Address - Phone:225-437-2362
Practice Address - Fax:225-743-2363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-07
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
LA0066193336C0003X
LAPHY.007558-IR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1936585OtherNCPDP PROVIDER IDENTIFICATION NUMBER