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General NPI Number Information
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NPI Number | 1932246261
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Entity Type | Organization
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Legal Business Name | HOSPITAL SERVICE DISTRICT 2 OF THE PARISH OF TANGIPAHOA STATE OF LA.
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 09/01/2017
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Provider Practice Location Address
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Address Line | 409 N W CENTRAL AVE
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City | AMITE
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State | LA
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Zip | 70422-2025
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Country | US
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Telephone | 985-748-7141
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Fax | 985-748-3181
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Provider Business Mailing Address
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Address Line | 409 N W CENTRAL AVE
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City | AMITE
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State | LA
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Zip | 70422-2428
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Country | US
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Telephone | 985-748-9485
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Fax | 985-748-8144
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Authorized Official
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Title or Position | CEO
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Name | MR. EDWARD C. DUGAR
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Credential |
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Telephone | 985-284-2404
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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 |
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 139-RHC2
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License Number State | LA
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