Healthcare Provider Details

I. General information

NPI: 1518364801
Provider Name (Legal Business Name): ST JAMES PARISH HOSP SERV DIST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2014
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21420 HIGHWAY 20
VACHERIE LA
70090-3614
US

IV. Provider business mailing address

1645 LUTCHER AVE
LUTCHER LA
70071-5150
US

V. Phone/Fax

Practice location:
  • Phone: 225-265-3013
  • Fax: 225-265-3775
Mailing address:
  • Phone: 225-258-5906
  • Fax: 225-869-5271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. MARY ELLEN PRATT
Title or Position: CEO
Credential:
Phone: 225-258-5900