Organization
IASIS GLENWOOD REGIONAL MEDICAL CENTER LP
Active
Parent organization
IASIS GLENWOOD REGIONAL MEDICAL CENTER LP
Organization subpart
Yes
Provider details
NPI number
Legal business name
IASIS GLENWOOD REGIONAL MEDICAL CENTER LP
Authorized official
JEREMY M TINNERELLO (HOSPITAL CEO)
(318) 329-4200
Entity
Organization
Contact information
Practice address
128 RIDGEDALE DR, WEST MONROE, LA 71291-2017
(318) 329-4525
(318) 329-4526
Mailing address
503 MCMILLAN ROAD, ATTN: BILLING, WEST MONROE, LA 71291-5327
(318) 329-4200
(318) 329-4710
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1705845
—
LA
Enumeration date
01/23/2007
Last updated
04/04/2018
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