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Organization

BIOMEDICAL RESEARCH FOUNDATION OF NORTHWEST LOUISIANA

Active
Other names
Southern Isotopes of Shreveport
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMES D DEAN (EXECUTIVE VICE PRESIDENT)
(318) 675-4111
Entity
Organization

Contact information

Practice address
1868 KINGS HWY, SHREVEPORT, LA 71103-3659
(318) 459-3719
(318) 459-3980
Mailing address
PO BOX 38050, SHREVEPORT, LA 71133-8050
(318) 675-4131
(318) 675-4120

Taxonomy

Speciality
Code
Description
License number
State
3336N0007X
Nuclear Pharmacy
Primary
PHY.005016-NU
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PHY.005016-NU
LOUISIANA BOARD OF PHARMACY PERMIT
LA
Enumeration date
01/02/2014
Last updated
01/02/2014
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