Provider Demographics
NPI:1538579032
Name:ST. TAMMANY PARISH HOSPITAL SERVICE DISTRICT NO 1
Entity type:Organization
Organization Name:ST. TAMMANY PARISH HOSPITAL SERVICE DISTRICT NO 1
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-898-4000
Mailing Address - Street 1:PO BOX 669379
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-9379
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:606 W 11TH AVE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-3630
Practice Address - Country:US
Practice Address - Phone:985-892-3766
Practice Address - Fax:985-893-9567
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. TAMMANY PARISH HOSPITAL SERVICE DISTRICT NO 1
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1791873Medicaid
LA1791873Medicaid