1356462782 NPI number — CHRISTUS HEALTH CENTRAL LOUISIANA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356462782 NPI number — CHRISTUS HEALTH CENTRAL LOUISIANA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHRISTUS HEALTH CENTRAL LOUISIANA
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:
1356462782
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/20/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3330 MASONIC DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALEXANDRIA
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71301-3841
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-483-4031
Provider Business Mailing Address Fax Number:
318-483-4044

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 HWY 3110
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NATCHITOCHES
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71457
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-354-1393
Provider Business Practice Location Address Fax Number:
318-354-1591
Provider Enumeration Date:
04/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WILSON
Authorized Official First Name:
MONTE
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
337-470-2100

Provider Taxonomy Codes

  • Taxonomy code: 261QS1000X , with the licence number:  234 , 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: 1446807 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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