Organization
ANANIAS INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHARLETTE EDWARDS MSPH (CEO)
(318) 227-9010
Entity
Organization
Contact information
Practice address
1612 FAIRFIELD AVE, SHREVEPORT, LA 71101-4306
(318) 227-9010
Mailing address
1612 FAIRFIELD AVE, SHREVEPORT, LA 71101-4306
(318) 227-9010
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018544695
DUNS
LA
Enumeration date
12/07/2010
Last updated
12/07/2010
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