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CH06192M DAVID RAINES COMMUNITY HEALTH CENTER, INC. (Active)
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Main Details
Name
DAVID RAINES COMMUNITY HEALTH CENTER, INC.
Subdivision Name
David Raines Community Health Center - Walnut Hill
Type
HRSA-Funded Health Center
Site ID
BPS-H80-032856
340B ID
CH06192M
Grant Number
H80CS00720
Additional Details
Current Program Status
Active
Registration Date
10/6/2021
Participating Start Date
1/1/2022
Participating Approval Date
10/7/2021
Last Recertification Date
2/18/2025
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
9360 Woolworth Rd Bldg
Shreveport, LA 71129-9362
Billing Address
David Raines Community Health Center
3041 Dr. MLK Jr 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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