Healthcare Provider Details

I. General information

NPI: 1013966928
Provider Name (Legal Business Name): HOSPITAL SERVICE DISTRICT NO. 1 OF THE PARISH OF VERMILION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 09/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 W 7TH ST
KAPLAN LA
70548-2910
US

IV. Provider business mailing address

1310 W 7TH ST
KAPLAN LA
70548-2910
US

V. Phone/Fax

Practice location:
  • Phone: 337-643-8300
  • Fax: 337-643-5233
Mailing address:
  • Phone: 337-643-8300
  • Fax: 337-643-5233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number149
License Number StateLA

VIII. Authorized Official

Name: MR. BRYCE QUEBODEAUX
Title or Position: CEO
Credential:
Phone: 337-643-5200