MEDICARE: CHRISTUS HEALTH NORTHERN LOUISIANA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0893235	OTHER	LA	CIGNA 20 SPRINT
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	HH7000	OTHER	TX	BCBSTX
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	0787749	OTHER	LA	AMERIGROUP
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	094645102	OTHER	LA	SUPERIOR HEALTH
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	90041	OTHER	LA	BLUE CROSS
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	127SCH170	OTHER	AL	BCBSAL
16	190041	OTHER	LA	STERLING OPTION 1

General Provider Information

NPI Number	:	1417950106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTUS HEALTH NORTHERN LOUISIANA

Provider Business Mailing Address
First Line	:	PO BOX 843577
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-3577
Country	:	US
Telephone Number	:	800-756-7999
Fax Number	:	469-282-1999

Provider Business Practice Location Address
First Line	:	1453 E BERT KOUNS INDUSTRIAL LOOP
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-6800
Country	:	US
Telephone Number	:	318-681-4500
Fax Number	:	318-681-4177

Authorized Official
Title or Position	:	CEO
Name	:	THOMAS STEEN TRAWICK
Credential	:
Telephone Number	:	318-681-5054

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	07/21/2022

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Directions to “CHRISTUS HEALTH NORTHERN LOUISIANA ” Practice Location

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