Basic Information
| Provider Information | |||||||||
| NPI: | 1184858953 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OPELOUSAS GENERAL HOSPITAL AUTHORITY | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1389 | ||||||||
| Address2: | |||||||||
| City: | OPELOUSAS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705711389 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3379483011 | ||||||||
| FaxNumber: | 3379485126 | ||||||||
| Practice Location | |||||||||
| Address1: | 3983 I 49 S SERVICE RD | ||||||||
| Address2: | |||||||||
| City: | OPELOUSAS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705700758 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3379483011 | ||||||||
| FaxNumber: | 3379485126 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2009 | ||||||||
| LastUpdateDate: | 02/25/2022 | ||||||||
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| AuthorizedOfficialLastName: | COCHRAN | ||||||||
| AuthorizedOfficialFirstName: | KENNETH | ||||||||
| AuthorizedOfficialMiddleName: | JOSEPH | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT CEO | ||||||||
| AuthorizedOfficialTelephone: | 3379483011 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | 02/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X | Y | Hospital Units | Psychiatric Unit |
No ID Information.