Provider Demographics
NPI:1386705788
Name:UNION GENERAL HOSPITAL
Entity type:Organization
Organization Name:UNION GENERAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLENDA
Authorized Official - Middle Name:W
Authorized Official - Last Name:BOYETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-368-7097
Mailing Address - Street 1:PO BOX 398
Mailing Address - Street 2:1065 MARION HWY
Mailing Address - City:FARMERVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71241
Mailing Address - Country:US
Mailing Address - Phone:318-368-9751
Mailing Address - Fax:318-368-7071
Practice Address - Street 1:1065 MARION HWY
Practice Address - Street 2:
Practice Address - City:FARMERVILLE
Practice Address - State:LA
Practice Address - Zip Code:71241-9314
Practice Address - Country:US
Practice Address - Phone:318-368-9751
Practice Address - Fax:318-368-7071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA138251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1401129Medicaid
LA1401129Medicaid
LA197115Medicare Oscar/Certification