Organization
ST CHARLES PARISH HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRED MARTINEZ (CEO)
(985) 785-6242
Entity
Organization
Contact information
Practice address
1057 PAUL MAILLARD RD, LULING, LA 70070-4349
(985) 785-6242
Mailing address
PO BOX 87, LULING, LA 70070-0087
(985) 785-6242
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
151
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760696546
BLUE CROSS BLUE SHIELD OF LA MEDICAL STAFF PROVIDER
LA
05
—
1796093
—
LA
Enumeration date
05/10/2007
Last updated
06/01/2023
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