# COMPLETE VITAL CARE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Complete Vital Care - Shreveport
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194749614
- **Authorized official:** GEORGE GARDINER (PRESIDENT)
- **Authorized official phone:** (318) 686-9995

## Contact information

- **Practice address:** 2530 BERT KOUNS INDUSTRIAL LOOP, STE 116, SHREVEPORT, LA 71118-3132
- **Practice address phone:** (318) 686-9995
- **Practice address fax:** (318) 686-9997
- **Mailing address:** PO BOX 5047, MERIDIAN, MS 39302-5047
- **Mailing address phone:** (800) 447-4095
- **Mailing address fax:** (601) 482-7490

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 4863 IR | LA | Yes |

## Other

- **Enumeration date:** 07/27/2006
- **Last updated:** 08/22/2020