MEDICARE: HOSPITAL SERVICE DISTRICT NO. 1 OF PLAQUEMINES PARISH

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
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1205856226
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPITAL SERVICE DISTRICT NO. 1 OF PLAQUEMINES PARISH

Provider Business Mailing Address
First Line	:	27136 HIGHWAY 23
Second Line	:
City	:	PORT SULPHUR
State	:	LA
Zip	:	70083-2648
Country	:	US
Telephone Number	:	504-564-3344
Fax Number	:	504-564-0174

Provider Business Practice Location Address
First Line	:	27136 HIGHWAY 23
Second Line	:
City	:	PORT SULPHUR
State	:	LA
Zip	:	70083-2648
Country	:	US
Telephone Number	:	504-564-3344
Fax Number	:	504-564-0174

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. LESLIE R PREST
Credential	:	RN
Telephone Number	:	504-564-3344

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	01/10/2024

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