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NPI 1275701518

NPI 1275701518 : HOSPITAL SERVICE DISTRICT NO. 2 : BREAUX BRIDGE, LA

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General NPI Number Information
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    NPI Number           |    1275701518
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    Entity Type          |    Organization 
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    Legal Business Name  |    HOSPITAL SERVICE DISTRICT NO. 2 
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Dates
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    Enumeration Date     |    02/20/2008
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    Last Update Date     |    08/18/2009
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Provider Practice Location Address
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    Address Line         |    210 CHAMPAGNE BLVD 
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    City                 |    BREAUX BRIDGE
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    State                |    LA
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    Zip                  |    70517-3700
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    Country              |    US
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    Telephone            |    337-507-1201
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    Fax                  |    337-332-5092
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Provider Business Mailing Address
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    Address Line         |    210 CHAMPAGNE BLVD 
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    City                 |    BREAUX BRIDGE
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    State                |    LA
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    Zip                  |    70517-3700
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    Country              |    US
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    Telephone            |    337-332-2178
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    Fax                  |    337-332-5092
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Authorized Official
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    Title or Position    |    CHIEF EXECUTIVE OFFICER
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    Name                 |    MRS. RENA B. MOUISSET 
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    Credential           |    
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    Telephone            |    337-507-1201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    282NC0060X
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    Taxonomy Name        |    Critical Access Hospital
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    License Number       |    240
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    License Number State |    LA
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