Organization
CRITICAL CARE MEDICINE SERVICES
Active
Parent organization
OUR LADY OF THE LAKE HOSPITAL, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
OUR LADY OF THE LAKE HOSPITAL, INC.
Authorized official
TAMARA WHITE (DIRECTOR OF BUSINESS SERVICES)
(225) 765-4251
Entity
Organization
Contact information
Practice address
7777 HENNESSY BLVD, SUITE 701, BATON ROUGE, LA 70808-4300
(225) 769-5864
Mailing address
7777 HENNESSY BLVD, SUITE 701, BATON ROUGE, LA 70808-4300
(225) 769-5864
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023604
—
LA
Enumeration date
10/15/2007
Last updated
05/19/2011
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