Provider Demographics
NPI:1225178387
Name:RED RIVER PHARMACY DIV. OF RAPIDES REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:RED RIVER PHARMACY DIV. OF RAPIDES REGIONAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO, RRMC
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:BEATTY
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:318-769-3156
Mailing Address - Street 1:211 FOURTH ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301
Mailing Address - Country:US
Mailing Address - Phone:318-769-3082
Mailing Address - Fax:318-769-7076
Practice Address - Street 1:211 FOURTH ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301
Practice Address - Country:US
Practice Address - Phone:318-769-3082
Practice Address - Fax:318-769-7076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2766 IR3336C0003X
LA3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1925443OtherNCPDP