Provider Demographics
NPI:1871632737
Name:RESPACARE OF LOUISIANA LLC
Entity Type:Organization
Organization Name:RESPACARE OF LOUISIANA LLC
Other - Org Name:RESPACAREPHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:S
Authorized Official - Last Name:VAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RESPIRATORY THERAPIS
Authorized Official - Phone:985-652-9933
Mailing Address - Street 1:719 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-5504
Mailing Address - Country:US
Mailing Address - Phone:985-652-9933
Mailing Address - Fax:985-652-9530
Practice Address - Street 1:6941 HIGHWAY 11
Practice Address - Street 2:STE A-3
Practice Address - City:CARRIERE
Practice Address - State:MS
Practice Address - Zip Code:39426-7793
Practice Address - Country:US
Practice Address - Phone:888-460-9933
Practice Address - Fax:985-652-9530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0569202.53336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4660680002Medicare NSC