Healthcare Provider Details

I. General information

NPI: 1356378715
Provider Name (Legal Business Name): WOMAN'S HOSPITAL FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 05/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7662 GOODWOOD BLVD SUITE B201
BATON ROUGE LA
70806-7622
US

IV. Provider business mailing address

7662 GOODWOOD BLVD SUITE B201
BATON ROUGE LA
70806-7622
US

V. Phone/Fax

Practice location:
  • Phone: 225-924-8174
  • Fax: 225-924-8476
Mailing address:
  • Phone: 225-924-8174
  • Fax: 225-924-8476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number3353 IR
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number3353 IR
License Number StateLA

VIII. Authorized Official

Name: TERI G FONTENOT
Title or Position: CEO & PRESIDENT
Credential:
Phone: 225-927-1300