Healthcare Provider Details

I. General information

NPI: 1295716637
Provider Name (Legal Business Name): HOSPITAL SERVICE DIST. NO. 1 OF THE PARISH OF ST. CHARLES, STATE OF LA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2005
Last Update Date: 10/11/2022
Certification Date: 10/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1057 PAUL MAILLARD RD
LULING LA
70070
US

IV. Provider business mailing address

PO BOX 87
LULING LA
70070-0087
US

V. Phone/Fax

Practice location:
  • Phone: 985-785-6242
  • Fax: 985-785-3623
Mailing address:
  • Phone: 985-785-6242
  • Fax: 985-785-3623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number151
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number151
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number151
License Number StateLA
# 4
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateLA

VIII. Authorized Official

Name: AUSTIN K. REEDER
Title or Position: CEO
Credential:
Phone: 985-785-3643