Healthcare Provider Details

I. General information

NPI: 1609053081
Provider Name (Legal Business Name): SWLHS ONCOLOGY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2008
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2770 3RD AVE STE 210
LAKE CHARLES LA
70601-0404
US

IV. Provider business mailing address

PO BOX 122579 DEPT 2579
DALLAS TX
75312-0001
US

V. Phone/Fax

Practice location:
  • Phone: 337-494-6768
  • Fax: 337-494-6792
Mailing address:
  • Phone: 337-494-2921
  • Fax: 337-494-6523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DAWN JOHNSON-HATCHER
Title or Position: CFO
Credential:
Phone: 337-494-2094