Provider Demographics
NPI:1336346451
Name:OCHSNER MEDICAL CENTER - HANCOCK LLC
Entity type:Organization
Organization Name:OCHSNER MEDICAL CENTER - HANCOCK LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-467-8744
Mailing Address - Street 1:149 DRINKWATER RD
Mailing Address - Street 2:
Mailing Address - City:BAY ST LOUIS
Mailing Address - State:MS
Mailing Address - Zip Code:39520-1658
Mailing Address - Country:US
Mailing Address - Phone:228-467-8744
Mailing Address - Fax:228-467-8799
Practice Address - Street 1:3068 PORT AND HARBOR DR
Practice Address - Street 2:
Practice Address - City:BAY ST LOUIS
Practice Address - State:MS
Practice Address - Zip Code:39520
Practice Address - Country:US
Practice Address - Phone:228-533-9000
Practice Address - Fax:228-467-8799
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OCHSNER MEDICAL CENTER - HANCOCK LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-02
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS11214261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09015655Medicaid
MS258500Medicare PIN