1144761255 NPI number — FRANKLIN PARISH HOSPITAL SERVICE DISTRICT NO1

Table of content: (NPI 1144761255)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144761255 NPI number — FRANKLIN PARISH HOSPITAL SERVICE DISTRICT NO1

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRANKLIN PARISH HOSPITAL SERVICE DISTRICT NO1
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:
REHABILITATION UNIT
Provider Other Organization Name Type Code:
5
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:
1144761255
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/03/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2106 LOOP RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINNSBORO
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71295-3344
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-435-9411
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2106 LOOP RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINNSBORO
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71295-3344
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-435-9411
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/09/2017

Additional Information

Authorized Official

Authorized Official Last Name:
BOONE
Authorized Official First Name:
CHARLOTTE
Authorized Official Middle Name:
GIDEON
Authorized Official Title or Position:
ADMINISTRATIVE ASSISTANT
Authorized Official Telephone Number:
318-412-5265

Provider Taxonomy Codes

  • Taxonomy code: 273Y00000X , with the licence number:  181 , 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: 1734888 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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