1811023823 NPI number — BATON ROUGE GENERAL MEDICAL CENTER

Table of content: (NPI 1811023823)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811023823 NPI number — BATON ROUGE GENERAL MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BATON ROUGE GENERAL MEDICAL CENTER
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:
Provider Other Organization Name Type Code:
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:
1811023823
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3600 FLORIDA BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BATON ROUGE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70806-3842
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-387-7000
Provider Business Mailing Address Fax Number:
225-381-6129

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3600 FLORIDA BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BATON ROUGE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70806-3842
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-387-7000
Provider Business Practice Location Address Fax Number:
225-381-6129
Provider Enumeration Date:
02/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
VIATOR
Authorized Official First Name:
DIONNE
Authorized Official Middle Name:
E
Authorized Official Title or Position:
SR VP AND CFO
Authorized Official Telephone Number:
225-763-1540

Provider Taxonomy Codes

  • Taxonomy code: 273Y00000X , with the licence number:  284 , 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: 371609 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1720020 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 40-4683087 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 73786 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 90065 . This is a "BLUE CROSS" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: BRG 0065N , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1900065 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000713688 , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 108819701 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2594830 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: LHVI10 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: XHSP41803 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 30-4683078 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 904221100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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