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1972549855

NPI Code Detail

MEDICARE: SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC

MEDICARE: SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION 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	282N00000X	General Acute Care Hospital	112	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0002	OTHER	LA	CHAMPUS ACUTE
2	0073977	OTHER	LA	AETNA - ALL
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	10494	OTHER	LA	BCBS MEDICAL STAFF
5	90060	OTHER	LA	BCBS ACUTE
6	04774	OTHER	LA	BCBS ER
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	190060	OTHER	TX	TX WORK COMP CARRIERS
11	375150400	OTHER	LA	DEPT OF LABOR
12	112	OTHER	LA	DHH LICENSE
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972549855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC

Provider Business Mailing Address
First Line	:	1701 OAK PARK BLVD
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-8911
Country	:	US
Telephone Number	:	337-494-3000
Fax Number	:	337-494-2947

Provider Business Practice Location Address
First Line	:	1701 OAK PARK BLVD
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-8911
Country	:	US
Telephone Number	:	337-494-3000
Fax Number	:	337-494-2947

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFIER
Name	:	MRS. DAWN JOHNSON
Credential	:
Telephone Number	:	337-494-2094

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	12/04/2023

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Practice Location Address:

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70601-8911

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1508816968 — TAMMY TATE-GOBERT ANP-C
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1730197211 — KEITH A BULLER P.A.
Practice Location Address:

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Directions to “SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC ” Practice Location

Language	Start Address	Practice Location

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