1255598298 NPI number — ALLEN PARISH HOSPITAL DISTRICT NO 3

Table of content: (NPI 1255598298)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255598298 NPI number — ALLEN PARISH HOSPITAL DISTRICT NO 3

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLEN PARISH HOSPITAL DISTRICT NO 3
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:
6
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:
1255598298
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/06/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1670
Provider Second Line Business Mailing Address:
108 6TH AVE
Provider Business Mailing Address City Name:
KINDER
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70648-3519
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-738-2527
Provider Business Mailing Address Fax Number:
337-738-4679

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
108 6TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINDER
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70648-3519
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-738-2527
Provider Business Practice Location Address Fax Number:
337-738-4679
Provider Enumeration Date:
05/19/2008

Additional Information

Authorized Official

Authorized Official Last Name:
REVIEL
Authorized Official First Name:
JACQUELINE
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
337-738-9479

Provider Taxonomy Codes

  • Taxonomy code: 275N00000X , with the licence number:  205 , 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: 1734691 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 61083 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1796689 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 19U133 . This is a "MEDICARE SKILLED NURSING FACILITY" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




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