# SPECIALISTS HOSPITAL OF SHREVEPORT LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Specialists Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831490531
- **Authorized official:** KENNETH WILHITE (PHARMACIST IN CHARGE)
- **Authorized official phone:** (318) 213-3350

## Contact information

- **Practice address:** 1500 LINE AVE, STE \#104B, SHREVEPORT, LA 71101-4639
- **Practice address phone:** (318) 213-3350
- **Practice address fax:** (318) 231-3811
- **Mailing address:** 1500 LINE AVE, 104B, SHREVEPORT, LA 71101-4639
- **Mailing address phone:** (318) 213-3350

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0002X | Clinic Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHY006385IR | LA | Yes |

## Other

- **Enumeration date:** 11/11/2010
- **Last updated:** 06/22/2016