Healthcare Provider Details

I. General information

NPI: 1669494654
Provider Name (Legal Business Name): SWLHS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2770 3RD AVE STE 300
LAKE CHARLES LA
70601-8994
US

IV. Provider business mailing address

PO BOX 122205 DEPT 2205
DALLAS TX
75312-2205
US

V. Phone/Fax

Practice location:
  • Phone: 337-494-6800
  • Fax: 337-494-4696
Mailing address:
  • Phone: 337-494-2921
  • Fax: 337-494-6523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

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