Provider Demographics
NPI:1699340794
Name:HOMER MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:HOMER MEMORIAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CQIO
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-927-2024
Mailing Address - Street 1:620 E COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:LA
Mailing Address - Zip Code:71040-3202
Mailing Address - Country:US
Mailing Address - Phone:318-927-2024
Mailing Address - Fax:
Practice Address - Street 1:912 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:LA
Practice Address - Zip Code:71040-3328
Practice Address - Country:US
Practice Address - Phone:318-927-3571
Practice Address - Fax:318-927-2677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-21
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care