Healthcare Provider Details

I. General information

NPI: 1518536259
Provider Name (Legal Business Name): HOMER MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2021
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 E COLLEGE ST
HOMER LA
71040-3202
US

IV. Provider business mailing address

620 E COLLEGE ST
HOMER LA
71040-3202
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: ANNA LEE JONES
Title or Position: CHIEF QUALITY AND INTEGRATION OFFIC
Credential:
Phone: 318-927-2024