Healthcare Provider Details

I. General information

NPI: 1750074050
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: 06/01/2023
Last Update Date: 07/06/2023
Certification Date: 07/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 MAIN ST
ZACHARY LA
70791-4039
US

IV. Provider business mailing address

6300 MAIN ST
ZACHARY LA
70791-4037
US

V. Phone/Fax

Practice location:
  • Phone: 225-658-4022
  • Fax: 225-658-4023
Mailing address:
  • Phone: 225-658-4022
  • Fax: 225-658-4023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LARRY MEESE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 225-658-4303