=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760348056
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOSPITAL SERVICE DISTRICT NO 1-A OF THE PARISH OF RICHLAND STATE OF LA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/30/2025
-----------------------------------------------------
Last Update Date | 12/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 407 CINCINNATI ST
-----------------------------------------------------
City | DELHI
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71232-3007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-878-6436
-----------------------------------------------------
Fax | 318-878-6420
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 407 CINCINNATI ST
-----------------------------------------------------
City | DELHI
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71232-3007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-878-6436
-----------------------------------------------------
Fax | 318-878-6420
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | REVENUE CYCLE MANAGER
-----------------------------------------------------
Name | KELLIE THOMAS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 318-878-6432
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------