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General NPI Number Information
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NPI Number | 1396861415
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Entity Type | Organization
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Legal Business Name | CITY OF SHREVEPORT
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 07/09/2010
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Provider Practice Location Address
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Address Line | 505 TRAVIS ST
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City | SHREVEPORT
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State | LA
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Zip | 71101-3042
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Country | US
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Telephone | 318-747-9977
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Fax | 318-747-9994
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Provider Business Mailing Address
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Address Line | PO BOX 34500
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City | SHREVEPORT
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State | LA
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Zip | 71130-4500
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Country | US
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Telephone | 318-747-9977
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Fax | 318-747-9994
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MS. SANDRA L NIEMI
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Credential |
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Telephone | 318-747-9977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 16332
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License Number State | LA
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