Provider Demographics
NPI:1093834608
Name:MADISON PARISH HOSPITAL SERVICE DISTRICT
Entity type:Organization
Organization Name:MADISON PARISH HOSPITAL SERVICE DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INTERIM CEO
Authorized Official - Prefix:
Authorized Official - First Name:SATIRA
Authorized Official - Middle Name:T
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-574-5080
Mailing Address - Street 1:PO BOX 1559
Mailing Address - Street 2:900 JOHNSON STREET
Mailing Address - City:TALLULAH
Mailing Address - State:LA
Mailing Address - Zip Code:71284-1559
Mailing Address - Country:US
Mailing Address - Phone:318-574-2374
Mailing Address - Fax:318-574-2396
Practice Address - Street 1:900 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:TALLULAH
Practice Address - State:LA
Practice Address - Zip Code:71282-4537
Practice Address - Country:US
Practice Address - Phone:318-574-2374
Practice Address - Fax:318-574-2396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA143282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1797511Medicaid
LA60010OtherBLUE CROSS
LA5D124Medicare UPIN