Provider Demographics
NPI:1356378715
Name:WOMAN'S HOSPITAL FOUNDATION
Entity type:Organization
Organization Name:WOMAN'S HOSPITAL FOUNDATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO & PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TERI
Authorized Official - Middle Name:G
Authorized Official - Last Name:FONTENOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-927-1300
Mailing Address - Street 1:7662 GOODWOOD BLVD
Mailing Address - Street 2:SUITE B201
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-7622
Mailing Address - Country:US
Mailing Address - Phone:225-924-8174
Mailing Address - Fax:225-924-8476
Practice Address - Street 1:7662 GOODWOOD BLVD
Practice Address - Street 2:SUITE B201
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-7622
Practice Address - Country:US
Practice Address - Phone:225-924-8174
Practice Address - Fax:225-924-8476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3353 IR251F00000X, 333600000X
332BX2000X, 332BP3500X, 3336H0001X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No251F00000XAgenciesHome Infusion
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1263419Medicaid
1068150002Medicare PIN