Provider Demographics
NPI:1982601944
Name:ALLEN PARISH HOSPITAL DISTRICT NO 3
Entity Type:Organization
Organization Name:ALLEN PARISH HOSPITAL DISTRICT NO 3
Other - Org Name:ALLEN PARISH HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:REVIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-738-9479
Mailing Address - Street 1:108 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:KINDER
Mailing Address - State:LA
Mailing Address - Zip Code:70648-3187
Mailing Address - Country:US
Mailing Address - Phone:337-738-9489
Mailing Address - Fax:337-738-5305
Practice Address - Street 1:108 6TH AVE
Practice Address - Street 2:
Practice Address - City:KINDER
Practice Address - State:LA
Practice Address - Zip Code:70648-3187
Practice Address - Country:US
Practice Address - Phone:337-738-9489
Practice Address - Fax:337-738-5305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA205273R00000X, 282N00000X
LAPHY.001289-HOS3336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
No282N00000XHospitalsGeneral Acute Care Hospital
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1734691Medicaid
2029938OtherPK
LA1705268Medicaid
1914236OtherCOMMERCIAL
1914236OtherCOMMERCIAL
190133Medicare PIN
19S133Medicare PIN