Provider Demographics
NPI:1205158243
Name:DREW, CAVINA ROSHAYE
Entity type:Individual
Prefix:
First Name:CAVINA
Middle Name:ROSHAYE
Last Name:DREW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1589 STUCKEY RD
Mailing Address - Street 2:
Mailing Address - City:DUBBERLY
Mailing Address - State:LA
Mailing Address - Zip Code:71024
Mailing Address - Country:US
Mailing Address - Phone:318-655-2110
Mailing Address - Fax:318-377-0809
Practice Address - Street 1:801 SHREVEPORT RD
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-3829
Practice Address - Country:US
Practice Address - Phone:318-655-2110
Practice Address - Fax:318-377-0809
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No251G00000XAgenciesHospice Care, Community Based