Healthcare Provider Details
I. General information
NPI: 1114252558
Provider Name (Legal Business Name): MOREHOUSE COMMUNITY MEDICAL CENTERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/02/2009
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1001 W MADISON AVE
BASTROP LA
71220-4331
US
IV. Provider business mailing address
PO BOX 792
BASTROP LA
71221-0792
US
V. Phone/Fax
- Phone: 318-281-8422
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 05544 |
| License Number State | LA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QF0400X |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KATIE
PARNELL
Title or Position: CEO
Credential:
Phone: 318-239-8015