Basic Information
| Provider Information | |||||||||
| NPI: | 1588629968 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OCHSNER MEDICAL CENTER - HANCOCK LLC | ||||||||
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| OtherOrganizationName: | OCHSNER MEDICAL CENTER - HANCOCK | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 149 DRINKWATER RD | ||||||||
| Address2: | |||||||||
| City: | BAY SAINT LOUIS | ||||||||
| State: | MS | ||||||||
| PostalCode: | 395201658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2284678787 | ||||||||
| FaxNumber: | 2284678799 | ||||||||
| Practice Location | |||||||||
| Address1: | 149 DRINKWATER BLVD | ||||||||
| Address2: | |||||||||
| City: | BAY SAINT LOUIS | ||||||||
| State: | MS | ||||||||
| PostalCode: | 39520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2284678600 | ||||||||
| FaxNumber: | 2284678799 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2006 | ||||||||
| LastUpdateDate: | 05/16/2018 | ||||||||
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| AuthorizedOfficialLastName: | HODGES | ||||||||
| AuthorizedOfficialFirstName: | ALAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF EXECUTIVE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 2284678744 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 11214 | MS | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 20166 | 01 | MS | B-CROSS ACUTE CARE | OTHER | 00020166 | 05 | MS | MEDICAID |