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General NPI Number Information
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NPI Number | 1780190322
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Entity Type | Organization
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Legal Business Name | CONCORDIA PARISH HOSPITAL SERVICE DISTRICT NUMBER ONE
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Dates
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Enumeration Date | 12/19/2017
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 1643 CARTER ST
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City | VIDALIA
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State | LA
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Zip | 71373-3156
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Country | US
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Telephone | 318-336-8707
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 111
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City | FERRIDAY
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State | LA
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Zip | 71334-0111
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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 | ADMINISTRATOR
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Name | NEKEISHA LASHAY SMITH
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Credential |
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Telephone | 318-719-3636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State | LA
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