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Organization

RAINBOW HEALTH ACCESS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRENDA L. MCINTYRE M.D. (PHYSICIAN - OWNER)
(318) 255-4112
Entity
Organization

Contact information

Practice address
206 E REYNOLDS DR, C-3, RUSTON, LA 71270-2809
(318) 255-4112
(318) 255-4174
Mailing address
PO BOX 13082, RUSTON, LA 71273-3082
(318) 255-4112
(318) 255-4174

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
202561
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1343072
LA
Enumeration date
09/23/2011
Last updated
09/23/2011
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