Organization
LAFOURCHE PARISH HOSPITAL SERVICE DISTRICT NO. 1
Active
Other names
Lady of the Sea Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KAREN COLLINS RN (CHIEF EXECUTIVE OFFICER)
(985) 632-6401
Entity
Organization
Contact information
Practice address
17108 W MAIN ST, CUT OFF, LA 70345-4104
(985) 632-4900
(985) 632-4907
Mailing address
200 W 134TH PL, CUT OFF, LA 70345-4143
(985) 632-4900
(985) 632-6401
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
013
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720089
—
LA
01
—
190048
ESRD
LA
Enumeration date
11/17/2005
Last updated
12/27/2022
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