| Iasis Glenwood Regional Medical Center Lp | |
|
128 Ridgedale Dr West Monroe LA 71291-2017 | |
| (318) 329-4525 | |
| (318) 329-4526 |
| Full Name | Iasis Glenwood Regional Medical Center Lp |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 128 Ridgedale Dr, West Monroe, Louisiana |
| Authorized Official Name and Position | Jeremy M Tinnerello (HOSPITAL CEO) |
| Authorized Official Contact | 3183294200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Iasis Glenwood Regional Medical Center Lp 503 Mcmillan Road Attn: Billing West Monroe LA 71291-5327 Ph: (318) 329-4200 | Iasis Glenwood Regional Medical Center Lp 128 Ridgedale Dr West Monroe LA 71291-2017 Ph: (318) 329-4525 |
| NPI Number | 1912052945 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 04/04/2018 |
| Medicare PECOS PAC ID | 9032212170 |
|---|---|
| Medicare Enrollment ID | O20070430000594 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912052945 | NPI | - | NPPES |
| 1705845 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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