Healthcare Provider Details

I. General information

NPI: 1619221348
Provider Name (Legal Business Name): CALCASIEU CAMERON HOSPITAL SERVICE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2012
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 STELLY LN
SULPHUR LA
70663-5134
US

IV. Provider business mailing address

1200 STELLY LN
SULPHUR LA
70663-5134
US

V. Phone/Fax

Practice location:
  • Phone: 337-312-1000
  • Fax:
Mailing address:
  • Phone: 337-312-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOBIE JAMES
Title or Position: CFO
Credential:
Phone: 337-527-4143