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General NPI Number Information
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NPI Number | 1609066646
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Entity Type | Organization
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Legal Business Name | HOMER MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 07/26/2007
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 620 EAST COLLEGE ST.
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City | HOMER
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State | LA
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Zip | 71040
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Country | US
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Telephone | 318-927-2024
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Fax | 318-927-9212
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Provider Business Mailing Address
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Address Line | PO BOX 809 620 E COLLEGE ST.
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City | HOMER
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State | LA
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Zip | 71040
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Country | US
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Telephone | 318-927-2024
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Fax | 318-972-9212
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Authorized Official
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Title or Position | CEO
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Name | TINA HAYNES
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Credential | RHIA
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Telephone | 318-927-2024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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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 | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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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 | 206
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License Number State | LA
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 206
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License Number State | LA
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