Organization
ST CHARLES PARISH HOSPITAL
Active
Other names
St Charles Parish Hospital Medical Staff
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FEDERICO MARTINEZ (CEO)
(985) 785-6242
Entity
Organization
Contact information
Practice address
1057 PAUL MAILLARD RD, LULING, LA 70070-4349
(985) 785-6242
(985) 785-3686
Mailing address
1057 PAUL MAILLARD RD, LULING, LA 70070-4349
(985) 785-6242
(985) 785-3686
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
151
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04845
BLUE CROSS BLUE SHIELD
LA
01
—
NJ0797
BLUE CROSS BLUE SHEILD
LA
Enumeration date
08/27/2010
Last updated
02/11/2011
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