Provider Demographics
NPI:1962676874
Name:ALLEGIANCE HOSPITAL OF MANY,LLC
Entity type:Organization
Organization Name:ALLEGIANCE HOSPITAL OF MANY,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROCK
Authorized Official - Middle Name:
Authorized Official - Last Name:BORDELON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-226-8202
Mailing Address - Street 1:240 HIGHLAND DR
Mailing Address - Street 2:SABINE MEDICAL CENTER
Mailing Address - City:MANY
Mailing Address - State:LA
Mailing Address - Zip Code:71449-3718
Mailing Address - Country:US
Mailing Address - Phone:318-256-1232
Mailing Address - Fax:318-256-1298
Practice Address - Street 1:1015 OBRIE ST
Practice Address - Street 2:
Practice Address - City:ZWOLLE
Practice Address - State:LA
Practice Address - Zip Code:71486-2510
Practice Address - Country:US
Practice Address - Phone:318-645-6168
Practice Address - Fax:318-645-6168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA643RHC2261QR1300X
LA643282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1037605Medicaid
LA193475Medicare Oscar/Certification