Organization
COMPLETE VITAL CARE, INC.
Active
Other names
Complete Vital Care - Shreveport
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE GARDINER (PRESIDENT)
(318) 686-9995
Entity
Organization
Contact information
Practice address
2530 BERT KOUNS INDUSTRIAL LOOP, STE 116, SHREVEPORT, LA 71118-3132
(318) 686-9995
(318) 686-9997
Mailing address
PO BOX 5047, MERIDIAN, MS 39302-5047
(800) 447-4095
(601) 482-7490
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
4863 IR
LA
Other
Enumeration date
07/27/2006
Last updated
08/22/2020
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