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Organization
DAVID RAINES COMMUNITY HEALTH CENTER INC
Active
Organization
DAVID RAINES COMMUNITY HEALTH CENTER INC
Active
Other names
DAVID RAINES COMMUNITY HEALTH CENTERS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIE WHITE (CEO)
(318) 227-3342
Entity
Organization
Contact information
Practice address
1625 DAVID RAINES RD, SHREVEPORT, LA 71107-5899
(318) 227-3355
(318) 227-3356
Mailing address
1625 DAVID RAINES RD, SHREVEPORT, LA 71107-5899
(318) 227-3355
(318) 227-3356
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0002X
Clinic Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
PHY.005457-IR
LA
3336M0003X
Managed Care Organization Pharmacy
—
NULL
Other
Enumeration date
07/25/2006
Last updated
12/22/2016
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