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General NPI Number Information
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NPI Number | 1689125072
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Entity Type | Organization
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Legal Business Name | MINDEN MEDICAL CENTER
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Dates
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Enumeration Date | 10/20/2016
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Last Update Date | 10/20/2016
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Provider Practice Location Address
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Address Line | 1 MEDICAL PLAZA PL
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City | MINDEN
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State | LA
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Zip | 71055-3330
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Country | US
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Telephone | 318-371-5638
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Fax |
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Provider Business Mailing Address
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Address Line | 1 MEDICAL PLAZA PL
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City | MINDEN
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State | LA
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Zip | 71055-3330
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE MANAGER
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Name | JOHN CRUMBLER
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Credential |
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Telephone | 318-371-5634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 13289
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License Number State | LA
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