Organization
ST TAMMANY PARISH HOSPITAL SERVICE DISTRICT NO 1
Active
Parent organization
ST TAMMANY PARISH HOSPITAL SERVICE DISTRICT NO 1
Other names
Northlake Pulmonary Associates at St Tammany Parish Hospital
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST TAMMANY PARISH HOSPITAL SERVICE DISTRICT NO 1
Authorized official
JOAN COFFMAN (PRESIDENT/CEO)
(985) 898-4000
Entity
Organization
Contact information
Practice address
1203 S TYLER ST STE 200, COVINGTON, LA 70433-2353
(985) 892-9143
(985) 892-9656
Mailing address
1203 S TYLER ST STE 200, COVINGTON, LA 70433-2353
(985) 892-9143
(985) 892-9656
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1943223
PROVIDER NUMBER
LA
Enumeration date
09/25/2019
Last updated
09/30/2019
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