Healthcare Provider Details
I. General information
NPI: 1811171085
Provider Name (Legal Business Name): STERLINGTON CRITICAL ACCESS HOSPITAL, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/24/2007
Last Update Date: 06/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
205 DAVENPORT STREET
MER ROUGE LA
71261
US
IV. Provider business mailing address
220 W DAVENPORT AVE
MER ROUGE LA
71261-3903
US
V. Phone/Fax
- Phone: 318-647-3142
- Fax: 318-647-5542
- Phone: 318-647-3412
- Fax: 318-647-5542
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | LA |
VIII. Authorized Official
Name:
CATHERINE
M
WALDROP
Title or Position: ADMINISTRATOR
Credential:
Phone: 318-665-9950