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Organization
SPECIALISTS HOSPITAL OF SHREVEPORT LLC
Active
Organization
SPECIALISTS HOSPITAL OF SHREVEPORT LLC
Active
Other names
Specialists Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH WILHITE (PHARMACIST IN CHARGE)
(318) 213-3350
Entity
Organization
Contact information
Practice address
1500 LINE AVE, STE #104B, SHREVEPORT, LA 71101-4639
(318) 213-3350
(318) 231-3811
Mailing address
1500 LINE AVE, 104B, SHREVEPORT, LA 71101-4639
(318) 213-3350
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
PHY006385IR
LA
Other
Enumeration date
11/11/2010
Last updated
06/22/2016
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