Basic Information
Provider Information
NPI: 1881678704
EntityType: 2
ReplacementNPI:  
OrganizationName: UNION GENERAL HOSPITAL
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 398
Address2: 901 JAMES AVE
City: FARMERVILLE
State: LA
PostalCode: 712410398
CountryCode: US
TelephoneNumber: 3183689751
FaxNumber: 3183687071
Practice Location
Address1: 901 JAMES AVE
Address2:  
City: FARMERVILLE
State: LA
PostalCode: 712412234
CountryCode: US
TelephoneNumber: 3183689751
FaxNumber: 3183687071
Other Information
ProviderEnumerationDate: 12/05/2005
LastUpdateDate: 11/16/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ORMOND
AuthorizedOfficialFirstName: EVALYN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CEO ADMINISTRATOR
AuthorizedOfficialTelephone: 3183687066
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/16/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282NC0060X146LAY HospitalsGeneral Acute Care HospitalCritical Access

ID Information
IDTypeStateIssuerDescription
179875405LA MEDICAID
19Z30101 SWING BEDOTHER
174357705LA MEDICAID


Home