Healthcare Provider Details

I. General information

NPI: 1831183748
Provider Name (Legal Business Name): HOMER MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 EAST COLLEGE ST
HOMER LA
71040-3202
US

IV. Provider business mailing address

620 EAST COLLEGE ST
HOMER LA
71040-3202
US

V. Phone/Fax

Practice location:
  • Phone: 318-927-2024
  • Fax: 318-927-9212
Mailing address:
  • Phone: 318-927-2024
  • Fax: 318-927-9212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number206
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number206
License Number State

VIII. Authorized Official

Name: TINA HAYNES
Title or Position: CEO
Credential:
Phone: 318-927-2024