Provider Demographics
NPI:1326396508
Name:GUEYDAN RX INC
Entity Type:Organization
Organization Name:GUEYDAN RX INC
Other - Org Name:MECHES FMAILY DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOOKKEEPER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EZEKIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-230-2153
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 1:104 MAIN ST
Practice Address - Street 2:
Practice Address - City:GUEYDAN
Practice Address - State:LA
Practice Address - Zip Code:70542-3528
Practice Address - Country:US
Practice Address - Phone:337-536-6115
Practice Address - Fax:337-536-5690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-21
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA65873336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1936458OtherNCPDP PROVIDER IDENTIFICATION NUMBER