MEDICARE: EAST CARROLL PARISH HOSPITAL

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	185	LA

Other Identifiers

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

General Provider Information

NPI Number	:	1982695441
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST CARROLL PARISH HOSPITAL

Provider Business Mailing Address
First Line	:	336 N HOOD ST
Second Line	:
City	:	LAKE PROVIDENCE
State	:	LA
Zip	:	71254-2140
Country	:	US
Telephone Number	:	318-559-4023
Fax Number	:	318-559-3761

Provider Business Practice Location Address
First Line	:	336 N HOOD ST
Second Line	:
City	:	LAKE PROVIDENCE
State	:	LA
Zip	:	71254-2140
Country	:	US
Telephone Number	:	318-559-4023
Fax Number	:	318-559-3761

Authorized Official
Title or Position	:	ADMINISTRATOR, CEO
Name	:	MRS. LADONNA ENGLERTH
Credential	:
Telephone Number	:	318-559-4023

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	10/08/2015

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