# OUR LADY OF THE LAKE HOSPITAL, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** OUR LADY OF THE LAKE HOSPITAL, INC.
- **Other names:** Our Lady of the Lake Children's Hospital Pharmacy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1659914513
- **Legal business name:** OUR LADY OF THE LAKE HOSPITAL, INC.
- **Authorized official:** MR. FRANK CANOVA JR. (VICE PRESIDENT OF FINANCE)
- **Authorized official phone:** (225) 765-6312

## Contact information

- **Practice address:** 8300 CONSTANTIN BLVD FL 2, BATON ROUGE, LA 70809-3489
- **Practice address phone:** (225) 765-8786
- **Practice address fax:** (225) 765-9906
- **Mailing address:** 8300 CONSTANTIN BLVD FL 2, BATON ROUGE, LA 70809-3489
- **Mailing address phone:** (225) 374-4325

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336I0012X | Institutional Pharmacy | — | — | Yes |

## Other

- **Enumeration date:** 10/23/2019
- **Last updated:** 10/23/2019