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General NPI Number Information
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NPI Number | 1376820936
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Entity Type | Organization
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Legal Business Name | BOGALUSA HEALTH CARE INC
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Dates
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Enumeration Date | 11/10/2011
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Last Update Date | 11/10/2011
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Provider Practice Location Address
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Address Line | 512 E 6TH ST
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City | BOGALUSA
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State | LA
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Zip | 70427-4706
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Country | US
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Telephone | 985-732-0401
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Fax | 985-732-0501
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Provider Business Mailing Address
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Address Line | 512 E 6TH ST
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City | BOGALUSA
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State | LA
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Zip | 70427-4706
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Country | US
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Telephone | 985-732-0401
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Fax | 985-732-0501
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Authorized Official
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Title or Position | CEO
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Name | VERNA WILLIAMS
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Credential | OWNER
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Telephone | 504-488-0050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174V00000X
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Taxonomy Name | Clinical Ethicist
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License Number |
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License Number State |
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