Organization
RURAL HEALTHCARE DEVELOPERS OF LOUISIANA LLC
Active
Other names
South Cameron Rural Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
RAY SHOEMAKER (CEO)
(662) 321-1155
Entity
Organization
Contact information
Practice address
10080 GULF HWY, LAKE CHARLES, LA 70607-8672
(337) 905-4111
(337) 905-5711
Mailing address
10080 GULF HWY, LAKE CHARLES, LA 70607-8672
(337) 905-4111
(337) 905-5711
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
534RHC-1
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1944335
—
LA
Enumeration date
12/19/2008
Last updated
12/19/2008
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