Organization
DAVID RAINES COMMUNITY HEALTH CENTER INC
Active
Other names
David Raines Community Health Centers Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIE WHITE (CEO)
(318) 227-3342
Entity
Organization
Contact information
Practice address
1514 DOCTORS DR, BOSSIER CITY, LA 71111-3379
(318) 841-6057
(318) 841-6058
Mailing address
1625 DAVID RAINES RD, SHREVEPORT, LA 71107-5899
(318) 425-2252
(318) 227-3359
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY006318IR
LA
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2127483
PK
—
Enumeration date
10/20/2010
Last updated
12/22/2016
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