Basic Information
| Provider Information | |||||||||
| NPI: | 1992172225 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FLOWSTREAM HEALTH SOLUTIONS, L.L.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1809 NORTHPOINTE LN | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | RUSTON | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712703853 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1809 NORTHPOINTE LN | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | RUSTON | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712703853 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3182557591 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2015 | ||||||||
| LastUpdateDate: | 11/17/2015 | ||||||||
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| AuthorizedOfficialLastName: | CASTON | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 3182557591 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.