Healthcare Provider Details

I. General information

NPI: 1912372897
Provider Name (Legal Business Name): HOSPITAL SERVICE DISTRICT NO 2 OF PARISH OF BEAUREGARD STATE OF LA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2015
Last Update Date: 04/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S WASHINGTON ST SUITE B
DERIDDER LA
70634-4861
US

IV. Provider business mailing address

600 S PINE ST
DERIDDER LA
70634-4942
US

V. Phone/Fax

Practice location:
  • Phone: 337-460-7688
  • Fax: 337-460-7691
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERT CHARRON
Title or Position: CEO
Credential:
Phone: 337-462-7100