Organization
A-1 NORTHWEST LA INCS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CINDY S PARKER R.N. (REGIONAL COORDINATOR)
(318) 636-0390
Entity
Organization
Contact information
Practice address
103 W ALABAMA AVE, RUSTON, LA 71270-4403
(318) 636-0390
(318) 635-3298
Mailing address
PO BOX 1345, RUSTON, LA 71273-1345
(318) 636-0390
(318) 635-3298
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
11882
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1714704
—
LA
Enumeration date
03/21/2007
Last updated
08/22/2020
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