Provider Demographics
NPI:1477856771
Name:RPE,INC
Entity Type:Organization
Organization Name:RPE,INC
Other - Org Name:RIVER PARISHES EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:GRANGER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:225-869-5043
Mailing Address - Street 1:10900 HIGHWAY 3125
Mailing Address - Street 2:STE F
Mailing Address - City:LUTCHER
Mailing Address - State:LA
Mailing Address - Zip Code:70071-5639
Mailing Address - Country:US
Mailing Address - Phone:225-869-5043
Mailing Address - Fax:225-869-8400
Practice Address - Street 1:10900 HIGHWAY 3125
Practice Address - Street 2:STE F
Practice Address - City:LUTCHER
Practice Address - State:LA
Practice Address - Zip Code:70071-5639
Practice Address - Country:US
Practice Address - Phone:225-869-5043
Practice Address - Fax:225-869-8400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-08
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA976-139T261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1360163Medicaid
LA1360163Medicaid