SHREVEPORT SURGERY CENTER PTRSHP NPI 1598804486

NPI Information

NPI: 1598804486
Provider Name: SHREVEPORT SURGERY CENTER PTRSHP
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 19D0723122

Address:
745 OLIVE ST
SUITE 100
SHREVEPORT, LA
ZIP 71104
Phone: (318) 227-1163
Get Directions

SHREVEPORT SURGERY CENTER PTRSHP is an ambulatory surgical clinic center in Shreveport, LA. SHREVEPORT SURGERY CENTER PTRSHP NPI is 1598804486. The provider is registered as an organization entity type.

The provider's business location address is:

745 OLIVE ST
SUITE 100
SHREVEPORT, LA
ZIP 71104-246
Phone: (318) 227-1163

The provider's authorized official is Mary Bridges .
The authorized official title is Administrator and has the following contact phone number (318) 227-1163.

The CLIA number assigned to this NPI record is 19D0723122 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/6/2007 and was last updated on 9/12/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	14	LOUISIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	11007	MEDICARE ID-TYPE UNSPECIFIED	LOUISIANA
2	21026	OTHER	LOUISIANA	BLUE CROSS BLUE SHIELD
3	1334073	MEDICAID	LOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »