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General NPI Number Information
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NPI Number | 1508809088
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Entity Type | Organization
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Legal Business Name | WASH-ST TAMMANY REG MEDICAL CENTER
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 03/15/2011
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Provider Practice Location Address
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Address Line | 433 PLAZA ST
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City | BOGALUSA
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State | LA
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Zip | 70427-3729
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Country | US
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Telephone | 985-730-6706
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Fax | 985-730-6709
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Provider Business Mailing Address
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Address Line | P.O. BOX 430
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City | BOGALUSA
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State | LA
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Zip | 70429-0430
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Country | US
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Telephone | 985-730-7181
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Fax | 985-730-7183
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Authorized Official
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Title or Position | CEO
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Name | KURT M. SCOTT
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Credential |
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Telephone | 985-730-6706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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