Healthcare Provider Details

I. General information

NPI: 1811213366
Provider Name (Legal Business Name): DEQUINCY MEMORIAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2010
Last Update Date: 06/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 W 4TH ST
DEQUINCY LA
70633-3508
US

IV. Provider business mailing address

PO BOX 1166
DEQUINCY LA
70633-1166
US

V. Phone/Fax

Practice location:
  • Phone: 337-786-2900
  • Fax: 337-786-1675
Mailing address:
  • Phone: 337-786-2900
  • Fax: 337-786-1675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number429
License Number StateLA

VIII. Authorized Official

Name: KAREN STRICKLAND
Title or Position: VP-REIMBURSEMENT
Credential:
Phone: 337-786-2900