Provider Demographics
NPI:1194969386
Name:PROMISE HOSPITAL OF BATON ROUGE, INC
Entity type:Organization
Organization Name:PROMISE HOSPITAL OF BATON ROUGE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EVP/GENERAL COUNSEL
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-869-3100
Mailing Address - Street 1:999 YAMATO ROAD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431
Mailing Address - Country:US
Mailing Address - Phone:561-869-3100
Mailing Address - Fax:561-826-0171
Practice Address - Street 1:615 E WORTHEY ROAD
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-4240
Practice Address - Country:US
Practice Address - Phone:225-621-1200
Practice Address - Fax:225-621-1419
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROMISE HOSPITAL OF BATON ROUGE,INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-01
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA192045Medicare Oscar/Certification