MAINSTREAM HEALTH LLC NPI 1639349491

NPI Information

NPI: 1639349491
Provider Name: MAINSTREAM HEALTH, LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
5930 MANSFIELD RD
SHREVEPORT, LA
ZIP 71108
Phone: (318) 636-1717
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MAINSTREAM HEALTH, LLC is a primary care clinic center in Shreveport, LA. MAINSTREAM HEALTH, LLC NPI is 1639349491. The provider is registered as an organization entity type.

The provider's business location address is:

5930 MANSFIELD RD
SHREVEPORT, LA
ZIP 71108-816
Phone: (318) 636-1717
Fax: (318) 636-1718

The provider's authorized official is Chidiadi Dike .
The authorized official title is Managing Member and has the following contact phone number (318) 636-1717.

The enumeration date for this NPI number is 3/8/2008 and was last updated on 6/11/2008.

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	261QP2300X	Clinic/Center	Primary Care			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	5DD34	MEDICARE PIN	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: 4/28/2024

NPI Synchronization or Removal

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