Organization
PANAKEIA HEALTH SERVICES, L.L.C.
Active
Other names
Stonewall Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SURESH K DONEPUDI M.D. (PRESIDENT)
(318) 688-5416
Entity
Organization
Contact information
Practice address
960 HWY. 171 SOUTH, STONEWALL, LA 71078
(318) 925-6660
(318) 925-6667
Mailing address
8921 MANSFIELD RD, SHREVEPORT, LA 71118-2144
(318) 688-5416
(318) 415-0205
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
194093
MEDICARE PROVIDER NUMBER
LA
Enumeration date
06/05/2007
Last updated
06/20/2008
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