Organization
RED RIVER CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES L COLLINS (N F ADMINISTRATOR)
(318) 747-1857
Entity
Organization
Contact information
Practice address
4820 MEDICAL DR, BOSSIER CITY, LA 71112-4562
(318) 747-1857
(318) 741-1259
Mailing address
4820 MEDICAL DR, BOSSIER CITY, LA 71112-4562
(318) 747-1857
(318) 741-1259
Taxonomy
Speciality
Code
Description
License number
State
332BN1400X
Nursing Facility Supplies (DME)
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
5309510002
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1620998
—
LA
Enumeration date
03/09/2007
Last updated
01/12/2009
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