1821046798 NPI number — LAIRD HOSPITAL, INC.

Table of content: (NPI 1821046798)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821046798 NPI number — LAIRD HOSPITAL, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAIRD HOSPITAL, INC.
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:
OCHSNER LAIRD HOSPITAL PROFESSIONAL SERVICES
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:
1821046798
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
DEPT. 3023, PO BOX 1000
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MEMPHIS
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38148-3023
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
601-213-3010
Provider Business Mailing Address Fax Number:
601-213-3011

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25117 HIGHWAY 15
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNION
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39365-9088
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-774-8214
Provider Business Practice Location Address Fax Number:
601-774-5401
Provider Enumeration Date:
05/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KENNEDY
Authorized Official First Name:
DON
Authorized Official Middle Name:
LARKIN
Authorized Official Title or Position:
REGIONAL CEO
Authorized Official Telephone Number:
601-703-9614

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 000476869 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: DC8220 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".




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