Organization
LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER
Active
Other names
Allied Health Clinics
Organization subpart
No
Provider details
NPI number
Authorized official
REVA MATTHIEW ROBINSON MBA (DIRECTOR OF CLIN MGMT SYSTEM)
(318) 813-2962
Entity
Organization
Contact information
Practice address
1450 CLAIBORNE AVE, SCHOOL OF ALLIED HEALTH PROFESSIONS, SHREVEPORT, LA 71103-4204
(318) 813-2963
(318) 813-2989
Mailing address
PO BOX 33932, SHREVEPORT, LA 71130-3932
(318) 813-2962
(318) 813-2975
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
332S00000X
Hearing Aid Equipment
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1035777
—
LA
Enumeration date
03/18/2008
Last updated
10/20/2020
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