Basic Information
| Provider Information | |||||||||
| NPI: | 1336173590 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | THE REGIONAL HEALTH SYSTEM OF ACADIANA, LLC | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | WOMEN'S & CHILDREN'S HOSPITAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4600 AMBASSADOR CAFFERY PKWY | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705086902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3375219100 | ||||||||
| FaxNumber: | 3375219102 | ||||||||
| Practice Location | |||||||||
| Address1: | 4600 AMBASSADOR CAFFERY PKWY | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705086902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3375219100 | ||||||||
| FaxNumber: | 3375219102 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2006 | ||||||||
| LastUpdateDate: | 03/22/2016 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | MILLER | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 3375219101 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 156921900 | 01 | US DEPT LABOR | OTHER | 1746657 | 05 | LA | MEDICAID | 275729 | 05 | FL | MEDICAID | 1764981 | 05 | LA | MEDICAID | 60031 | 01 | LA | BCBS | OTHER | 624196 | 01 | HEALTHLINK | OTHER |