Basic Information
| Provider Information | |||||||||
| NPI: | 1487311825 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNION GENERAL HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 398 | ||||||||
| Address2: | |||||||||
| City: | FARMERVILLE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712410398 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3183689751 | ||||||||
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| Practice Location | |||||||||
| Address1: | 901 JAMES AVE | ||||||||
| Address2: | |||||||||
| City: | FARMERVILLE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712412234 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3183689751 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/19/2021 | ||||||||
| LastUpdateDate: | 09/08/2022 | ||||||||
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| AuthorizedOfficialLastName: | ORMOND | ||||||||
| AuthorizedOfficialFirstName: | EVALYN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 3183689751 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 09/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | I4199 | 01 | BLUE CROSS | OTHER |