Provider Demographics
NPI:1164930335
Name:RAPIDES NURSING SERVICES
Entity Type:Organization
Organization Name:RAPIDES NURSING SERVICES
Other - Org Name:LEGACY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING EMPOYEE
Authorized Official - Prefix:
Authorized Official - First Name:DARRYL
Authorized Official - Middle Name:
Authorized Official - Last Name:MONROE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-445-0408
Mailing Address - Street 1:1201 N BOLTON AVE STE E
Mailing Address - Street 2:SUITE E
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-7459
Mailing Address - Country:US
Mailing Address - Phone:318-319-6640
Mailing Address - Fax:318-445-2982
Practice Address - Street 1:1201 N BOLTON AVE STE E
Practice Address - Street 2:SUITE E
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-7459
Practice Address - Country:US
Practice Address - Phone:318-319-6640
Practice Address - Fax:318-445-2982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-22
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
LA0075883336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2175416OtherPK