Provider Demographics
NPI:1437229077
Name:DUSON RX, INC.
Entity Type:Organization
Organization Name:DUSON RX, INC.
Other - Org Name:MECHE'S FAMILY DRUGS OF DUSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAPHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MECHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-873-6182
Mailing Address - Street 1:9021 CAMERON ST
Mailing Address - Street 2:
Mailing Address - City:DUSON
Mailing Address - State:LA
Mailing Address - Zip Code:70529
Mailing Address - Country:US
Mailing Address - Phone:337-873-6182
Mailing Address - Fax:337-873-7629
Practice Address - Street 1:9021 CAMERON ST.
Practice Address - Street 2:
Practice Address - City:DUSON
Practice Address - State:LA
Practice Address - Zip Code:70529
Practice Address - Country:US
Practice Address - Phone:337-873-6182
Practice Address - Fax:337-334-9899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4959-IR333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1269603Medicaid