| Casse/chi Bert Kouns Site | |
|
2120 Bert Kouns Industrial Loop Suite A Shreveport LA 71118-3351 | |
| (318) 688-3350 | |
| (318) 688-3655 |
| Full Name | Casse/chi Bert Kouns Site |
|---|---|
| Speciality | Clinic/Center |
| Location | 2120 Bert Kouns Industrial Loop, Shreveport, Louisiana |
| Authorized Official Name and Position | Mary M Chumley (CEO/PRESIDENT) |
| Authorized Official Contact | 3186883350 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Casse/chi Bert Kouns Site 2120 Bert Kouns Industrial Loop Suite A Shreveport LA 71118-3351 Ph: (318) 688-3350 | Casse/chi Bert Kouns Site 2120 Bert Kouns Industrial Loop Suite A Shreveport LA 71118-3351 Ph: (318) 688-3350 |
| NPI Number | 1134532062 |
|---|---|
| Provider Enumeration Date | 06/09/2014 |
| Last Update Date | 07/24/2020 |
| Medicare PECOS PAC ID | 8022043710 |
|---|---|
| Medicare Enrollment ID | O20160908002074 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134532062 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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