Organization Name: | WASHINGTON ST. TAMMANY REGIONAL MEDICAL CENTER |
NPI Number: | 1073641866 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DONALD R SMITHBURG (VICE CHANCELLOR CEO) |
Mailing Address: | 1403 North Ave Bogalusa |
State: | LA US |
Postal Code: | 704274428 |
Phone Number: | 9857327122 |
Fax Number: | |
NPI Enumeration Date: | 03/01/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QS1000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Student Health |
Taxonomy Definition: |