Organization
HOSPITAL SERVICE DISTRICT NO. 2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RENA B MOUISSET (CHIEF EXECUTIVE OFFICER)
(337) 332-2178
Entity
Organization
Contact information
Practice address
210 CHAMPAGNE BLVD, BREAUX BRIDGE, LA 70517-3700
(337) 332-2178
(337) 332-5092
Mailing address
PO BOX 357, BREAUX BRIDGE, LA 70517-0357
(337) 332-2178
(337) 332-5092
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
240
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1734730
—
LA
01
—
60782
HOSPITAL (BLUE CROSS)
LA
Enumeration date
05/27/2005
Last updated
08/18/2009
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