| David Raines Community Health Center, Inc | |
|
1625 David Raines Rd Shreveport LA 71107-5899 | |
| (318) 425-2252 | |
| Not Available |
| Full Name | David Raines Community Health Center, Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1625 David Raines Rd, Shreveport, Louisiana |
| Authorized Official Name and Position | Willie C White (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3182273342 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David Raines Community Health Center, Inc 3041 Dr Martin Luther King Dr Shreveport LA 71107-4705 Ph: (318) 227-3350 | David Raines Community Health Center, Inc 1625 David Raines Rd Shreveport LA 71107-5899 Ph: (318) 425-2252 |
| NPI Number | 1265216451 |
|---|---|
| Provider Enumeration Date | 08/21/2023 |
| Last Update Date | 08/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265216451 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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Paul S Wilson Md And Willis-knighton Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1666 E Bert Kouns Industrial Loop, Suite 230, Shreveport, LA 71105 Phone: 318-212-3970 Fax: 318-212-3975 | |
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