Basic Information
| Provider Information | |||||||||
| NPI: | 1568626273 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ALLEGIANCE HOSPITAL OF MANY,LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | SABINE MEDICAL CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 504 TEXAS ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SHREVEPORT | ||||||||
| State: | LA | ||||||||
| PostalCode: | 711013524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3182268202 | ||||||||
| FaxNumber: | 3182268205 | ||||||||
| Practice Location | |||||||||
| Address1: | 240 HIGHLAND DR | ||||||||
| Address2: | |||||||||
| City: | MANY | ||||||||
| State: | LA | ||||||||
| PostalCode: | 714493718 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3182565691 | ||||||||
| FaxNumber: | 3182567543 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2008 | ||||||||
| LastUpdateDate: | 07/23/2008 | ||||||||
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| AuthorizedOfficialLastName: | BORDELON | ||||||||
| AuthorizedOfficialFirstName: | ROCK | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 3182268202 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 275N00000X | N | Hospital Units | Medicare Defined Swing Bed Unit | 282N00000X | 539 | LA | Y | Hospitals | General Acute Care Hospital |
No ID Information.