Provider Demographics
NPI:1952525453
Name:HOSPITAL SERVICE DISTRICT NO 1 PARISH OF AVOYELLES STATE OF LOUISIANA
Entity Type:Organization
Organization Name:HOSPITAL SERVICE DISTRICT NO 1 PARISH OF AVOYELLES STATE OF LOUISIANA
Other - Org Name:BUNKIE GENERAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:DEGLANDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:3183-469-6681
Mailing Address - Street 1:PO BOX 380
Mailing Address - Street 2:
Mailing Address - City:BUNKIE
Mailing Address - State:LA
Mailing Address - Zip Code:71322-0380
Mailing Address - Country:US
Mailing Address - Phone:318-346-6681
Mailing Address - Fax:318-346-3330
Practice Address - Street 1:427 EVERGREEN ST
Practice Address - Street 2:
Practice Address - City:BUNKIE
Practice Address - State:LA
Practice Address - Zip Code:71322-3901
Practice Address - Country:US
Practice Address - Phone:318-346-6681
Practice Address - Fax:318-346-3330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1705489Medicaid
LA1705489Medicaid