Healthcare Provider Details

I. General information

NPI: 1386705788
Provider Name (Legal Business Name): UNION GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 04/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1065 MARION HWY
FARMERVILLE LA
71241-9314
US

IV. Provider business mailing address

PO BOX 398 1065 MARION HWY
FARMERVILLE LA
71241
US

V. Phone/Fax

Practice location:
  • Phone: 318-368-9751
  • Fax: 318-368-7071
Mailing address:
  • Phone: 318-368-9751
  • Fax: 318-368-7071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number138
License Number StateLA

VIII. Authorized Official

Name: MRS. GLENDA W BOYETTE
Title or Position: BUSINESS OFFICE DIRECTOR
Credential:
Phone: 318-368-7097