Red River Center LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

RED RIVER CENTER LLC

Practice address

3405 Mansfield Rd
Shreveport, LA 71103-4107

Phone

(318) 222-3100

Fax

(318) 222-3930

NPI assigned

Mar 6, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Edward Neal Killian

Title

Administrator

Phone

(318) 222-3100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Roseview Nursing Center Supply Co. Doing business as

Tax ID family

Red River Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Red River Center LLC

  • Nursing Facility Supplies (DME)
  • Bossier City, LA
  • NPI 1275665887
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245369974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 MANSFIELD RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034107",
            "telephone_number": "318-222-3100",
            "fax_number": "318-222-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 MANSFIELD RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034107",
            "telephone_number": "318-222-3100",
            "fax_number": "318-222-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED RIVER CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KILLIAN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "NEAL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "318-222-3100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1621161",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roseview Nursing Center Supply Co.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• MD Ibrahim Razu, MBBS
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• Red River Cardiovascular Surgeons LLC
• Red River Center LLC
• Red River Consultants, Inc
• Red River Medicine, LLC
• Red River Orthotic Specialists, LLC
• Red River Pediatric Clinic, LLC

• Durable Medical Equipment & Medical Supplies in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Durable Medical Equipment & Medical Supplies in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.