Organization
SIMBA VENTURES HOSPITAL LA, LLC
Active
Other names
Doctors' Hospital Shreveport
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK R. PFEIL (CHEIF FINANCIAL OFFICER)
(972) 265-3115
Entity
Organization
Contact information
Practice address
1130 LOUISIANA AVE, SHREVEPORT, LA 71101-3908
(318) 227-1211
(318) 678-4112
Mailing address
1130 LOUISIANA AVE, SHREVEPORT, LA 71101-3908
(318) 227-1211
(318) 678-4112
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1749150
—
TX
01
—
60652
BLUE CROSS
LA
Enumeration date
08/05/2007
Last updated
06/02/2008
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