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NPI Code Detail

MEDICARE: JENNINGS AMERICAN LEGION HOSPITAL, INC.

MEDICARE: JENNINGS AMERICAN LEGION HOSPITAL, INC.
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
1275N00000XMedicare Defined Swing Bed Hospital Unit138LA
2282N00000XGeneral Acute Care Hospital138LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21900663961OTHERCLIA

General Provider Information

NPI Number : 1114921160
Entity Type Code : Organization
Provider Name (Legal Business Name) : JENNINGS AMERICAN LEGION HOSPITAL, INC.
Provider Business Mailing Address
First Line : 1634 ELTON RD
Second Line :
City : JENNINGS
State : LA
Zip : 70546-3614
Country : US
Telephone Number : 337-616-7030
Fax Number : 337-616-7034
Provider Business Practice Location Address
First Line : 1634 ELTON RD
Second Line :
City : JENNINGS
State : LA
Zip : 70546-3614
Country : US
Telephone Number : 337-616-7030
Fax Number : 337-616-7034
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : MR. DANA D WILLIAMS
Credential :
Telephone Number : 337-616-7030
Provider Enumeration Date : 06/08/2005
Last Update Date : 10/26/2021

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