MEDICARE: HOSPITAL SERVICE DISTRICT #2 OF LASALLE 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	261QR1300X	Rural Health Clinic/Center
2	261QR1300X	Rural Health Clinic/Center	231RHC-2	LA

General Provider Information

NPI Number	:	1912173352
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPITAL SERVICE DISTRICT #2 OF LASALLE PARISH

Provider Business Mailing Address
First Line	:	P.O. BOX 2780
Second Line	:
City	:	JENA
State	:	LA
Zip	:	71342
Country	:	US
Telephone Number	:	318-992-6311
Fax Number	:	318-992-9245

Provider Business Practice Location Address
First Line	:	180 NINTH ST
Second Line	:
City	:	JENA
State	:	LA
Zip	:	71342-3900
Country	:	US
Telephone Number	:	318-992-6311
Fax Number	:	318-992-9245

Authorized Official
Title or Position	:	ADMINISTRATIVE ASSISTANT
Name	:	MRS. LANA B. FRANCIS
Credential	:
Telephone Number	:	318-992-9150

Provider Enumeration Date	:	05/06/2008
Last Update Date	:	01/20/2012

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