OrganizationActive
New Tech
NPI 1396290060 · Non-Pharmacy Dispensing Site · Shreveport, LA
Provider details
- NPI number
- 1396290060
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Organization subpart
- No
- Authorized official
- Trent Jackson, Director of Alternate Care(800) 710-9348
Specialties & taxonomies
Suppliers
Practice location
410 Kay Ln
Shreveport, LA 71115-3604
Phone: (800) 710-9348
Approximate (ZIP-level) locationGet directions
Mailing address
410 Kay Ln
Shreveport, LA 71115-3604
Registry dates
- Enumerated
- 2016-08-23
- Last updated
- 2016-08-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.