Healthcare Provider Details

I. General information

NPI: 1811653686
Provider Name (Legal Business Name): ACADIA GENERAL HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2021
Last Update Date: 12/07/2021
Certification Date: 12/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 WRIGHT AVE STE H
CROWLEY LA
70526-2226
US

IV. Provider business mailing address

PO BOX 53247
LAFAYETTE LA
70505-3247
US

V. Phone/Fax

Practice location:
  • Phone: 337-785-5440
  • Fax: 337-785-5441
Mailing address:
  • Phone: 337-289-8944
  • Fax: 337-571-0030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. PATRICK GANDY
Title or Position: CEO
Credential:
Phone: 337-289-7743