Provider Demographics
NPI:1003954199
Name:LOUISIANA PAIN CARE
Entity Type:Organization
Organization Name:LOUISIANA PAIN CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-323-6405
Mailing Address - Street 1:210 LAYTON AVENUE
Mailing Address - Street 2:SUITE 20
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71210
Mailing Address - Country:US
Mailing Address - Phone:318-323-6405
Mailing Address - Fax:
Practice Address - Street 1:210 LAYTON AVENUE
Practice Address - Street 2:SUITE 20
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71210
Practice Address - Country:US
Practice Address - Phone:318-323-6405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain