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General NPI Number Information
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NPI Number | 1003244781
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Entity Type | Organization
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Legal Business Name | BYRD REGIONAL HOSPITAL
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Dates
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Enumeration Date | 10/16/2013
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Last Update Date | 10/16/2013
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Provider Practice Location Address
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Address Line | 1020 W. FERTITTA BLVD.
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City | LEESVILLE
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State | LA
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Zip | 71446
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Country | US
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Telephone | 337-239-9041
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 W. FERTITTA BLVD.
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City | LEESVILLE
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State | LA
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Zip | 71446
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Country | US
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Telephone | 337-239-9041
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MR. WENDELL WILKES
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Credential |
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Telephone | 337-239-5112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NR1301X
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Taxonomy Name | Rural Acute Care Hospital
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License Number | 190
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License Number State | LA
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