Provider Demographics
NPI:1346022621
Name:RAPHA EXPRESS
Entity Type:Organization
Organization Name:RAPHA EXPRESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ATIEN
Authorized Official - Middle Name:MARIUS
Authorized Official - Last Name:KOUASSI
Authorized Official - Suffix:
Authorized Official - Credentials:CSCM
Authorized Official - Phone:916-248-1026
Mailing Address - Street 1:5366 KANKAKEE DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-3058
Mailing Address - Country:US
Mailing Address - Phone:916-248-1026
Mailing Address - Fax:
Practice Address - Street 1:5366 KANKAKEE DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95835-3058
Practice Address - Country:US
Practice Address - Phone:916-248-1026
Practice Address - Fax:916-543-1831
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAPHA EXPRESS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care