Healthcare Provider Details

I. General information

NPI: 1760534622
Provider Name (Legal Business Name): AMERICAN LEGION HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 03/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 CROWLEY RAYNE HWY
CROWLEY LA
70526-8202
US

IV. Provider business mailing address

1305 CROWLEY RAYNE HWY
CROWLEY LA
70526-8202
US

V. Phone/Fax

Practice location:
  • Phone: 337-783-3222
  • Fax: 337-788-6598
Mailing address:
  • Phone: 337-783-3222
  • Fax: 337-788-6598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARMAINE VIDRINE
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 337-783-3222