Provider Demographics
NPI:1265601751
Name:AMERICAN RED CROSS - NORTHWEST LOUISIANA CHAPTER
Entity type:Organization
Organization Name:AMERICAN RED CROSS - NORTHWEST LOUISIANA CHAPTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEALTH & SAFETY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:LAGERSEN
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-865-9545
Mailing Address - Street 1:4221 LINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71108-3121
Mailing Address - Country:US
Mailing Address - Phone:318-865-9545
Mailing Address - Fax:318-868-4111
Practice Address - Street 1:4221 LINWOOD AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71108-3121
Practice Address - Country:US
Practice Address - Phone:318-865-9545
Practice Address - Fax:318-868-4111
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN RED CROSS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable