Organization
OUR LADY OF THE LAKE HOSPITAL INC
Active
Parent organization
OUR LADY OF THE LAKE HOSPITAL INC
Other names
OLOL Assumption ER Physicians
Organization subpart
Yes
Provider details
NPI number
Legal business name
OUR LADY OF THE LAKE HOSPITAL INC
Authorized official
MR. WAYNE M ARBONEAUX (CEO)
(985) 369-3600
Entity
Organization
Contact information
Practice address
135 HWY 402, NAPOLEONVILLE, LA 70390
(985) 369-3600
(985) 369-4236
Mailing address
8415 GOODWOOD BLVD, SUITE 105, BATON ROUGE, LA 70806
(225) 765-4361
(225) 765-4062
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
451
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1948217
—
LA
Enumeration date
02/13/2007
Last updated
04/15/2011
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