Healthcare Provider Details

I. General information

NPI: 1780046508
Provider Name (Legal Business Name): HOSPITAL SERVICE DISTRICT 1 OF EAST BATON ROUGE PARISH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 01/26/2020
Certification Date: 01/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19900 OLD SCENIC HWY SUITE H/I
ZACHARY LA
70791-7368
US

IV. Provider business mailing address

2335 CHURCH ST STE E
ZACHARY LA
70791-2700
US

V. Phone/Fax

Practice location:
  • Phone: 225-570-2618
  • Fax: 225-570-8539
Mailing address:
  • Phone: 225-570-2489
  • Fax: 225-570-2986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LARRY R MEESE
Title or Position: CEO
Credential:
Phone: 225-658-4303