Organization
RED RIVER CENTER LLC
Active
Other names
Roseview Nursing Center Supply Co.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD NEAL KILLIAN (ADMINISTRATOR)
(318) 222-3100
Entity
Organization
Contact information
Practice address
3405 MANSFIELD RD, SHREVEPORT, LA 71103-4107
(318) 222-3100
(318) 222-3930
Mailing address
3405 MANSFIELD RD, SHREVEPORT, LA 71103-4107
(318) 222-3100
(318) 222-3930
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1621161
—
LA
Enumeration date
03/06/2007
Last updated
08/22/2020
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