Basic Information
| Provider Information | |||||||||
| NPI: | 1730786120 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OCHSNER MEDICAL CENTER - HANCOCK, LLC | ||||||||
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| OtherOrganizationName: | OCHSNER HEALTH CENTER- EAST PICAYUNE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 149 DRINKWATER RD | ||||||||
| Address2: | |||||||||
| City: | BAY ST LOUIS | ||||||||
| State: | MS | ||||||||
| PostalCode: | 395201658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2284678600 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2274 HIGHWAY 43 S STE 200 | ||||||||
| Address2: | |||||||||
| City: | PICAYUNE | ||||||||
| State: | MS | ||||||||
| PostalCode: | 394668141 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6013479024 | ||||||||
| FaxNumber: | 6017985914 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/08/2020 | ||||||||
| LastUpdateDate: | 10/08/2020 | ||||||||
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| AuthorizedOfficialLastName: | POSECAI | ||||||||
| AuthorizedOfficialFirstName: | SCOTT | ||||||||
| AuthorizedOfficialMiddleName: | J. | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE VICE PRESIDENT & CFO | ||||||||
| AuthorizedOfficialTelephone: | 5048424097 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | OCHSNER MEDICAL CENTER - HANCOCK, LLC | ||||||||
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| NPICertificationDate: | 10/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.