Healthcare Provider Details

I. General information

NPI: 1780650150
Provider Name (Legal Business Name): UNION GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 12/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 TAYLOR ST
MARION LA
71260-3653
US

IV. Provider business mailing address

3150 TAYLOR ST
MARION LA
71260-3653
US

V. Phone/Fax

Practice location:
  • Phone: 318-292-2795
  • Fax: 318-292-2785
Mailing address:
  • Phone: 318-292-2795
  • Fax: 318-292-2785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number146RH2
License Number StateLA

VIII. Authorized Official

Name: MS. EVALYN F ORMOND
Title or Position: ADMINISTRATOR
Credential:
Phone: 318-368-7090