Provider Demographics
NPI:1083975486
Name:ZACHARY RX INC
Entity Type:Organization
Organization Name:ZACHARY RX INC
Other - Org Name:CARE RX EXPRESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAPHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MECHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-334-3399
Mailing Address - Street 1:PO BOX 578
Mailing Address - Street 2:
Mailing Address - City:RAYNE
Mailing Address - State:LA
Mailing Address - Zip Code:70578-0578
Mailing Address - Country:US
Mailing Address - Phone:337-334-9979
Mailing Address - Fax:337-334-9899
Practice Address - Street 1:2400 CHURCH POINT HWY STE A
Practice Address - Street 2:
Practice Address - City:RAYNE
Practice Address - State:LA
Practice Address - Zip Code:70578-7661
Practice Address - Country:US
Practice Address - Phone:225-658-0608
Practice Address - Fax:800-729-0167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-01
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA65163336C0003X
3336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2135405OtherPK