Provider Demographics
NPI:1285785089
Name:ALLEN PARISH HOSPITAL DISTRICT NO 3
Entity type:Organization
Organization Name:ALLEN PARISH HOSPITAL DISTRICT NO 3
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:REVIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-738-9478
Mailing Address - Street 1:108 6TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:KINDER
Mailing Address - State:LA
Mailing Address - Zip Code:70648-1670
Mailing Address - Country:US
Mailing Address - Phone:337-738-4721
Mailing Address - Fax:337-738-4726
Practice Address - Street 1:108 6TH AVE BLDG B
Practice Address - Street 2:
Practice Address - City:KINDER
Practice Address - State:LA
Practice Address - Zip Code:70648-3187
Practice Address - Country:US
Practice Address - Phone:337-738-9494
Practice Address - Fax:337-738-9449
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLEN PARISH HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA205261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1454842Medicaid