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Organization
ST. TAMMANY PARISH HOSPITAL DISTRIC #1
Active
Organization
ST. TAMMANY PARISH HOSPITAL DISTRIC #1
Active
Other names
Cancer Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE L GOODWIN (CREDENTIALING SPECIALIST)
(985) 898-4493
Entity
Organization
Contact information
Practice address
1202 S TYLER ST, COVINGTON, LA 70433-2330
(985) 898-4410
(985) 871-5935
Mailing address
1202 S TYLER ST, COVINGTON, LA 70433-2330
(985) 898-4410
(985) 871-5935
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
104
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720259
—
LA
01
—
1796131
MEDICARE
LA
01
—
190045
MEDICARE
—
01
—
5CS20
MEDICARE
—
01
—
90045
BLUE CROSS
LA
Enumeration date
03/09/2011
Last updated
09/30/2019
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