Provider Demographics
NPI:1972805661
Name:OUR LADY OF LOURDES RMC
Entity type:Organization
Organization Name:OUR LADY OF LOURDES RMC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:'BUD'
Authorized Official - Last Name:BARROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-289-2100
Mailing Address - Street 1:611 SAINT LANDRY ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-4627
Mailing Address - Country:US
Mailing Address - Phone:337-289-2100
Mailing Address - Fax:
Practice Address - Street 1:4809 AMBASSADOR CAFFERY PKWY
Practice Address - Street 2:STE 430
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508
Practice Address - Country:US
Practice Address - Phone:337-236-3411
Practice Address - Fax:337-236-3118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-01
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty