MEDICARE: ETHICUS HOSPITAL-SHREVEPORT, LLC

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	282N00000X	General Acute Care Hospital	APPLIED FOR	LA

General Provider Information

NPI Number	:	1649201104
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ETHICUS HOSPITAL-SHREVEPORT, LLC

Provider Business Mailing Address
First Line	:	3 RIVERWAY
Second Line	:	SUITE 1810
City	:	HOUSTON
State	:	TX
Zip	:	77056-1919
Country	:	US
Telephone Number	:	713-572-2222
Fax Number	:	713-572-2273

Provider Business Practice Location Address
First Line	:	2105 AIRLINE DR
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-3105
Country	:	US
Telephone Number	:	713-572-2222
Fax Number	:	713-572-2273

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ROBERT A. LOEPP JR.
Credential	:
Telephone Number	:	318-218-6411

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1548264211 — DR. KURT THOMAS GROZINGER M.D.
Practice Location Address:

2105 AIRLINE DR
BOSSIER CITY, LA
71111-3105

Practice Phone: 318-741-6078
Practice Fax:

1265410583 — RADIOLOGY IMAGING ASSOCIATES, LLP
Practice Location Address:

2105 AIRLINE DR , RADIOLOGY DEPARTMENT
BOSSIER CITY, LA
71111-3105

Practice Phone: 318-741-6078
Practice Fax:

1912970948 — DR. HAROLD OSCAR PADEN JR. M.D.
Practice Location Address:

2125 AIRLINE DR
BOSSIER CITY, LA
71111-3105

Practice Phone: 318-773-9320
Practice Fax:

1750345419 — BOSSIER SPECIALTY HOSPITAL LLC
Practice Location Address:

2105 AIRLINE DR
BOSSIER CITY, LA
71111-3105

Practice Phone: 318-549-2011
Practice Fax: 318-549-2077

1760497937 — WALGREEN CO
Practice Location Address:

2107 AIRLINE DR
BOSSIER CITY, LA
71111-3105

Practice Phone: 318-742-5590
Practice Fax:

1851402655 — MR. MARTIC SMITH CRNA
Practice Location Address:

2105 AIRLINE DR
BOSSIER CITY, LA
71111-3105

Practice Phone: 318-549-2011
Practice Fax:

Directions to “ETHICUS HOSPITAL-SHREVEPORT, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.