Organization
CONCORDIA PARISH HOSPITAL SERVICE DISTRICT NUMBER ONE
Active
Other names
TRINITY MEDICAL VIDALIA CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
NEKEISHA LASHAY SMITH (ADMINISTRATOR)
(318) 719-3636
Entity
Organization
Contact information
Practice address
1643 CARTER ST, VIDALIA, LA 71373-3156
(318) 336-8707
Mailing address
PO BOX 111, FERRIDAY, LA 71334-0111
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2481011
—
LA
Enumeration date
12/19/2017
Last updated
10/05/2022
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