Provider Demographics
NPI:1427061167
Name:HOSPITAL SERVICE DISTRICT #2 OF LASALLE PARISH
Entity type:Organization
Organization Name:HOSPITAL SERVICE DISTRICT #2 OF LASALLE PARISH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALLYSON
Authorized Official - Middle Name:C
Authorized Official - Last Name:FANNIN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA, CFO
Authorized Official - Phone:318-992-9200
Mailing Address - Street 1:PO BOX 2780
Mailing Address - Street 2:
Mailing Address - City:JENA
Mailing Address - State:LA
Mailing Address - Zip Code:71342-2780
Mailing Address - Country:US
Mailing Address - Phone:318-992-9200
Mailing Address - Fax:318-992-9280
Practice Address - Street 1:212 NINTH ST
Practice Address - Street 2:
Practice Address - City:JENA
Practice Address - State:LA
Practice Address - Zip Code:71342-2780
Practice Address - Country:US
Practice Address - Phone:318-992-9200
Practice Address - Fax:318-992-9280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA66251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1400581Medicaid
LA1400581Medicaid