Healthcare Provider Details

I. General information

NPI: 1245544923
Provider Name (Legal Business Name): MOREHOUSE GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2010
Last Update Date: 01/03/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 GUNBY AVE
BASTROP LA
71220-4406
US

IV. Provider business mailing address

PO BOX 293
BASTROP LA
71221-0293
US

V. Phone/Fax

Practice location:
  • Phone: 318-283-3920
  • Fax: 318-239-8920
Mailing address:
  • Phone: 318-283-3620
  • Fax: 318-239-8620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ELMORE PATTERSON
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 318-283-3602