Provider Demographics
NPI:1972549855
Name:SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC
Entity type:Organization
Organization Name:SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFIER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-494-2094
Mailing Address - Street 1:1701 OAK PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-8911
Mailing Address - Country:US
Mailing Address - Phone:337-494-3000
Mailing Address - Fax:337-494-2947
Practice Address - Street 1:1701 OAK PARK BLVD
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8911
Practice Address - Country:US
Practice Address - Phone:337-494-3000
Practice Address - Fax:337-494-2947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA112282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA0002OtherCHAMPUS ACUTE
LA0073977OtherAETNA - ALL
MS0020349Medicaid
LA10494OtherBCBS MEDICAL STAFF
LA90060OtherBCBS ACUTE
LA04774OtherBCBS ER
LA1796794Medicaid
LA1720461Medicaid
CAXHSP41087Medicaid
TX190060OtherTX WORK COMP CARRIERS
LA375150400OtherDEPT OF LABOR
LA112OtherDHH LICENSE
TX130043603Medicaid
LA0002OtherCHAMPUS ACUTE
LA90060OtherBCBS ACUTE