Organization Name: | BEAUREGARD FAMILY MEDICAL CENTER, LLC |
NPI Number: | 1326387705 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DARRELL L KINGHAM (CFO) |
Mailing Address: | 501 S Pine St Deridder |
State: | LA US |
Postal Code: | 706344939 |
Phone Number: | 3374627106 |
Fax Number: | 3374627479 |
NPI Enumeration Date: | 02/05/2013 |
NPI Last Update Date: | 02/05/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |