Healthcare Provider Details

I. General information

NPI: 1124590864
Provider Name (Legal Business Name): LOURDES HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2018
Last Update Date: 02/17/2024
Certification Date: 02/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 CARONDELET DR
RICHLAND WA
99354-3300
US

IV. Provider business mailing address

1175 CARONDELET DR
RICHLAND WA
99354-3300
US

V. Phone/Fax

Practice location:
  • Phone: 509-946-7108
  • Fax:
Mailing address:
  • Phone: 509-946-7108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHARLOTTE E LAWRENCE
Title or Position: SECRETARY
Credential:
Phone: 615-920-7000