MEDICARE: HOSPITAL SERVICE DISTRICT NO. 1 OF POINTE COUPEE, LOUISIANA, INC.

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	251E00000X	Home Health Agency	176	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578566261
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPITAL SERVICE DISTRICT NO. 1 OF POINTE COUPEE, LOUISIANA, INC.

Provider Business Mailing Address
First Line	:	350 HOSPITAL RD
Second Line	:
City	:	NEW ROADS
State	:	LA
Zip	:	70760-2621
Country	:	US
Telephone Number	:	225-638-5717
Fax Number	:	225-638-5849

Provider Business Practice Location Address
First Line	:	350 HOSPITAL RD
Second Line	:
City	:	NEW ROADS
State	:	LA
Zip	:	70760-2621
Country	:	US
Telephone Number	:	225-638-5717
Fax Number	:	225-638-5849

Authorized Official
Title or Position	:	CEO
Name	:	JEANINE LAURENT THIBODEAUX
Credential	:	RN
Telephone Number	:	225-618-2802

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	05/10/2022

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