Organization
SPECIALISTS HOSPITAL SHREVEPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KANDI MOORE CEO (CEO)
(318) 213-3800
Entity
Organization
Contact information
Practice address
1500 LINE AVENUE, SUITE 206, SHREVEPORT, LA 71101
(318) 213-3800
Mailing address
1500 LINE AVENUE, SUITE 206, SHREVEPORT, LA 71101
(318) 213-3800
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
011350
LA
Other
Enumeration date
05/14/2014
Last updated
05/14/2014
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