1225183916 NPI number — CATAHOULA PARISH HOSPITAL DISTRICT NO. 2

Table of content: (NPI 1225183916)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225183916 NPI number — CATAHOULA PARISH HOSPITAL DISTRICT NO. 2

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CATAHOULA PARISH HOSPITAL DISTRICT NO. 2
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MEDICAL CENTER FAMILY DENTISTRY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225183916
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/15/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8
Provider Second Line Business Mailing Address:
307 CHISUM STREET
Provider Business Mailing Address City Name:
SICILY ISLAND
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71368-0008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-389-5727
Provider Business Mailing Address Fax Number:
318-389-4028

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
307 CHISUM ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SICILY ISLAND
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71368-4807
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-389-9941
Provider Business Practice Location Address Fax Number:
318-389-4028
Provider Enumeration Date:
01/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MIESCH
Authorized Official First Name:
DEBRA
Authorized Official Middle Name:
K
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
318-389-5727

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X , with the licence number:  5539 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1940801 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1855391 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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