Healthcare Provider Details

I. General information

NPI: 1619428588
Provider Name (Legal Business Name): STERLINGTON CRITICAL ACCESS HOSPITAL L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2016
Last Update Date: 06/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 W HICKORY AVE
BASTROP LA
71220-4441
US

IV. Provider business mailing address

355 W HICKORY AVE
BASTROP LA
71220-4441
US

V. Phone/Fax

Practice location:
  • Phone: 318-665-9950
  • Fax:
Mailing address:
  • Phone: 318-665-9950
  • Fax: 318-665-9950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: CATHY WALDROP
Title or Position: CEO
Credential:
Phone: 318-665-9950