Healthcare Provider Details

I. General information

NPI: 1710932470
Provider Name (Legal Business Name): HOSPITAL SERVICE DISTRICT NO1 PARISH OF AVOYELLES STATE OF LOUISIANA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
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: 318-346-3330
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 Number184
License Number StateLA

VIII. Authorized Official

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