MEDICARE: ST JAMES PARISH HOSP SERV DIST

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363LF0000X	Family Nurse Practitioner
2	208D00000X	General Practice Physician
3	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1518364801
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST JAMES PARISH HOSP SERV DIST

Provider Business Mailing Address
First Line	:	1645 LUTCHER AVE
Second Line	:
City	:	LUTCHER
State	:	LA
Zip	:	70071-5150
Country	:	US
Telephone Number	:	225-258-5906
Fax Number	:	225-869-5271

Provider Business Practice Location Address
First Line	:	21420 HIGHWAY 20
Second Line	:
City	:	VACHERIE
State	:	LA
Zip	:	70090-3614
Country	:	US
Telephone Number	:	225-265-3013
Fax Number	:	225-265-3775

Authorized Official
Title or Position	:	CEO
Name	:	MS. MARY ELLEN PRATT
Credential	:
Telephone Number	:	225-258-5900

Provider Enumeration Date	:	12/02/2014
Last Update Date	:	06/18/2025

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