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General NPI Number Information
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NPI Number | 1689077430
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Entity Type | Organization
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Legal Business Name | UNIVERSITY HEALTH SHREVEPORT LLC
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Dates
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Enumeration Date | 10/07/2014
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 1606 KINGS HWY RM 2263
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City | SHREVEPORT
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State | LA
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Zip | 71103-4128
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Country | US
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Telephone | 318-626-0454
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Fax | 318-626-3222
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Provider Business Mailing Address
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Address Line | 1541 KINGS HWY ATTN: PHARMACY RM AG-13
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City | SHREVEPORT
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State | LA
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Zip | 71103-4228
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Country | US
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Telephone | 318-626-0863
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Fax | 318-626-3222
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Authorized Official
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Title or Position | AVP, PHARMACY
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Name | JASON LAFITTE
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Credential |
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Telephone | 318-560-7698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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