Organization
IASIS GLENWOOD REGIONAL MEDICAL CENTER LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY M TINNERELLO (HOSPITAL CEO)
(318) 329-4200
Entity
Organization
Contact information
Practice address
503 MCMILLAN RD, WEST MONROE, LA 71291-5327
(318) 329-4200
(318) 329-4710
Mailing address
503 MCMILLAN ROAD, ATTN: BILLING, WEST MONROE, LA 71291-5327
(318) 329-4200
(318) 329-4710
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1731382
—
LA
Enumeration date
01/18/2007
Last updated
04/04/2018
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