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General NPI Number Information
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NPI Number | 1003919168
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Entity Type | Organization
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Legal Business Name | MONROE MEDICAL MANAGEMENT
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3736 N MARKET ST SUITE 100
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City | SHREVEPORT
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State | LA
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Zip | 71107-3104
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Country | US
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Telephone | 318-934-0092
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Fax | 318-934-0097
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Provider Business Mailing Address
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Address Line | 8856 YOUREE DR STE D
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City | SHREVEPORT
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State | LA
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Zip | 71115-2514
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Country | US
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Telephone | 318-797-8859
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHARON C MONROE
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Credential |
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Telephone | 318-518-8188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number |
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License Number State |
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