# DAVID RAINES COMMUNITY HEALTH CENTER INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** DAVID RAINES COMMUNITY HEALTH CENTERS PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861415721
- **Authorized official:** WILLIE WHITE (CEO)
- **Authorized official phone:** (318) 227-3342

## Contact information

- **Practice address:** 1625 DAVID RAINES RD, SHREVEPORT, LA 71107-5899
- **Practice address phone:** (318) 227-3355
- **Practice address fax:** (318) 227-3356
- **Mailing address:** 1625 DAVID RAINES RD, SHREVEPORT, LA 71107-5899
- **Mailing address phone:** (318) 227-3355
- **Mailing address fax:** (318) 227-3356

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0002X | Clinic Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHY.005457-IR | LA | Yes |
| 3336M0003X | Managed Care Organization Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 07/25/2006
- **Last updated:** 12/22/2016