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Organization

SPECIALISTS HOSPITAL SHREVEPORT, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEVIN W JENKINS MHA (CEO/ADMINISTRATOR)
(318) 213-3800
Entity
Organization

Contact information

Practice address
1500 LINE AVE, SUITE 206, SHREVEPORT, LA 71101-4622
(318) 213-3800
(318) 213-3801
Mailing address
1500 LINE AVE, SUITE 206, SHREVEPORT, LA 71101-4622
(318) 213-3800
(318) 213-3801

Taxonomy

Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1702439
LA
Enumeration date
05/28/2007
Last updated
01/03/2024
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