Healthcare Provider Details

I. General information

NPI: 1144227935
Provider Name (Legal Business Name): CONCORDIA PARISH HOSPITAL SERVICE DISTRICT NUMBER ONE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 10/05/2022
Certification Date: 10/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6569 HIGHWAY 84
FERRIDAY LA
71334-4573
US

IV. Provider business mailing address

PO BOX 111
FERRIDAY LA
71334-0111
US

V. Phone/Fax

Practice location:
  • Phone: 318-757-6551
  • Fax: 318-757-6832
Mailing address:
  • Phone: 318-757-6551
  • Fax: 318-403-3263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number247
License Number StateLA

VIII. Authorized Official

Name: NEKEISHA SMITH
Title or Position: ADMINISTRATOR
Credential:
Phone: 318-757-6551