Ethicus Hospital-Shreveport, LLC

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

APPLIED FOR Issued in LA

Legal business name

ETHICUS HOSPITAL-SHREVEPORT, LLC

Practice address

2105 Airline Dr
Bossier City, LA 71111-3105

Phone

(713) 572-2222

Fax

(713) 572-2273

NPI assigned

Jul 5, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Robert A. Loepp Jr.

Title

President

Phone

(318) 218-6411

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649201104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 RIVERWAY",
            "address_2": "SUITE 1810",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770561919",
            "telephone_number": "713-572-2222",
            "fax_number": "713-572-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 AIRLINE DR",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711113105",
            "telephone_number": "713-572-2222",
            "fax_number": "713-572-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHICUS HOSPITAL-SHREVEPORT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOEPP",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-218-6411",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "LA",
            "license": "APPLIED FOR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.