Provider Demographics
NPI:1205944998
Name:HOSPITAL SERVICE DISTRICT NO. 1 OF CALDWELL PARISH
Entity type:Organization
Organization Name:HOSPITAL SERVICE DISTRICT NO. 1 OF CALDWELL PARISH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:O
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:318-649-5300
Mailing Address - Street 1:554 COLLINS RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:LA
Mailing Address - Zip Code:71418-3388
Mailing Address - Country:US
Mailing Address - Phone:318-649-5300
Mailing Address - Fax:318-649-0052
Practice Address - Street 1:554 COLLINS RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:LA
Practice Address - Zip Code:71418-3388
Practice Address - Country:US
Practice Address - Phone:318-649-5300
Practice Address - Fax:318-649-0052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA090261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1443930Medicaid
LA193446Medicare Oscar/Certification
LA1443930Medicaid