Healthcare Provider Details

I. General information

NPI: 1790094985
Provider Name (Legal Business Name): HAMMOND SURGICAL HOSPITAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2010
Last Update Date: 08/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42570 S. AIRPORT ROAD
HAMMOND LA
70403
US

IV. Provider business mailing address

42570 S. AIRPORT ROAD
HAMMOND LA
70403
US

V. Phone/Fax

Practice location:
  • Phone: 985-510-6200
  • Fax: 985-510-6202
Mailing address:
  • Phone: 985-510-6200
  • Fax: 985-510-6202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number690
License Number StateLA

VIII. Authorized Official

Name: MR. DONALD D. TREXLER
Title or Position: CEO
Credential:
Phone: 985-510-6200