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NPI Code Detail

MEDICARE: G. B. COOLEY HOSPITAL SERVICE DISTRICT

MEDICARE: G. B. COOLEY HOSPITAL SERVICE DISTRICT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1320600000XIntellectual and/or Developmental Disabilities Residential Treatment Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013133925
Entity Type Code : Organization
Provider Name (Legal Business Name) : G. B. COOLEY HOSPITAL SERVICE DISTRICT
Provider Business Mailing Address
First Line : 364 GB COOLEY RD
Second Line :
City : WEST MONROE
State : LA
Zip : 71291-8866
Country : US
Telephone Number : 318-396-6300
Fax Number : 318-396-7663
Provider Business Practice Location Address
First Line : 364 GB COOLEY RD
Second Line :
City : WEST MONROE
State : LA
Zip : 71291-8866
Country : US
Telephone Number : 318-396-6300
Fax Number : 318-396-7663
Authorized Official
Title or Position : DIRECTOR OF ACCOUNTING
Name : MR. JIMMY SANDERLIN
Credential :
Telephone Number : 318-396-6300
Provider Enumeration Date : 04/18/2007
Last Update Date : 08/22/2020

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Directions to “G. B. COOLEY HOSPITAL SERVICE DISTRICT ” Practice Location

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