Healthcare Provider Details

I. General information

NPI: 1356306971
Provider Name (Legal Business Name): IASIS OUACHITA COMMUNITY HOSPITAL LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 10/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 GLENWOOD DRIVE
WEST MONROE LA
71291-5539
US

IV. Provider business mailing address

117 SEABOARD LN BLDG E ATTN: IASIS CORPORATE LEGAL DEPARTMENT
FRANKLIN TN
37067-2855
US

V. Phone/Fax

Practice location:
  • Phone: 318-322-1339
  • Fax: 318-322-1693
Mailing address:
  • Phone: 615-844-2747
  • Fax: 615-467-1271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number633
License Number StateLA

VIII. Authorized Official

Name: MATTHEW ROBERTS
Title or Position: OFFICER
Credential:
Phone: 318-329-4200