Organization
GREEN CLINIC SURGICAL HOSPITAL CRNA GROUP
Active
Parent organization
GREEN CLINIC SURGICAL HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREEN CLINIC SURGICAL HOSPITAL
Authorized official
MR. JAMES MCCLUNG (ADMINISTRATOR)
(318) 232-7700
Entity
Organization
Contact information
Practice address
1118 S FARMERVILLE ST, RUSTON, LA 71270-5914
(318) 232-7700
(318) 232-1092
Mailing address
1118 S FARMERVILLE ST, RUSTON, LA 71270-5914
(318) 232-7700
(318) 232-1092
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H4674
BLUE CROSS OF LA
LA
Enumeration date
12/13/2007
Last updated
12/13/2007
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