Healthcare Provider Details

I. General information

NPI: 1730680919
Provider Name (Legal Business Name): IBERIA GENERAL HOSPITAL & MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2018
Last Update Date: 02/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N LEWIS ST
NEW IBERIA LA
70563-2043
US

IV. Provider business mailing address

PO BOX 13338
NEW IBERIA LA
70562-3338
US

V. Phone/Fax

Practice location:
  • Phone: 337-364-0441
  • Fax:
Mailing address:
  • Phone: 337-364-0441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: AMY B GAUDET
Title or Position: DIRECTOR REVENUE CYCLE
Credential:
Phone: 337-374-7566