Healthcare Provider Details

I. General information

NPI: 1639377294
Provider Name (Legal Business Name): BUNKIE GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2007
Last Update Date: 11/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 EVERGREEN ST
BUNKIE LA
71322-3901
US

IV. Provider business mailing address

PO BOX 380
BUNKIE LA
71322-0380
US

V. Phone/Fax

Practice location:
  • Phone: 318-346-6681
  • Fax:
Mailing address:
  • Phone: 318-346-6681
  • Fax: 318-346-3330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: LATRICE WILLIAMS
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 318-346-6681