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CH06192T DAVID RAINES COMMUNITY HEALTH CENTER INC (Approved)
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Main Details
Name
DAVID RAINES COMMUNITY HEALTH CENTER INC
Subdivision Name
David Raines CHC School Based Health Center-Broadmoor Stem Academy
Type
HRSA-Funded Health Center
Site ID
BPS-H80-038974
340B ID
CH06192T
Grant Number
H80CS00720
Additional Details
Current Program Status
Approved
Registration Date
4/2/2025
Participating Start Date
7/1/2025
Participating Approval Date
4/8/2025
Last Recertification Date
Contacts
Authorizing Official
David Raines Community Health Centers
Willie C. White III, CEO
(318) 227-3349 Ext: 3160
Primary Contact
David Raines Community Health Centers
Myrtis Edwards, COO
(318) 227-3342
Addresses
Street Address
441 Atlantic Ave
Shreveport, LA 71105-2911
Billing Address
David Raines Community Health Center
3041 Dr Martin Luther King Dr
Shreveport, LA 71107-4705
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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