Provider Demographics
NPI:1205036274
Name:RPB MEDICAL SERVICES, LLC
Entity Type:Organization
Organization Name:RPB MEDICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:P
Authorized Official - Last Name:BURDEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, BC
Authorized Official - Phone:318-396-6807
Mailing Address - Street 1:425 STANDARD REED RD
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-1609
Mailing Address - Country:US
Mailing Address - Phone:318-396-6807
Mailing Address - Fax:318-396-6807
Practice Address - Street 1:5328 CYPRESS ST
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-7506
Practice Address - Country:US
Practice Address - Phone:318-397-3636
Practice Address - Fax:318-397-3639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-18
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAPO4819261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CY35Medicare PIN