MEDICARE: HOSPITAL SERVICE DISTRICT #1 OF EAST BATON ROUGE PARISH

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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1750074050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPITAL SERVICE DISTRICT #1 OF EAST BATON ROUGE PARISH

Provider Business Mailing Address
First Line	:	6300 MAIN ST
Second Line	:
City	:	ZACHARY
State	:	LA
Zip	:	70791-4037
Country	:	US
Telephone Number	:	225-658-4022
Fax Number	:	225-658-4023

Provider Business Practice Location Address
First Line	:	6400 MAIN ST
Second Line	:
City	:	ZACHARY
State	:	LA
Zip	:	70791-4039
Country	:	US
Telephone Number	:	225-658-4022
Fax Number	:	225-658-4023

Authorized Official
Title or Position	:	CHIEF EXECUTIVE ROLE
Name	:	FRANK CORCORAN
Credential	:
Telephone Number	:	225-658-4303

Provider Enumeration Date	:	06/01/2023
Last Update Date	:	01/22/2026

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