Provider Demographics
NPI:1477970168
Name:RAPIDES HEALTHCARE SYSTEM, LLC
Entity type:Organization
Organization Name:RAPIDES HEALTHCARE SYSTEM, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:C.E.O./ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:E
Authorized Official - Last Name:COBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-769-3150
Mailing Address - Street 1:211 4TH ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-8421
Mailing Address - Country:US
Mailing Address - Phone:318-769-3150
Mailing Address - Fax:318-769-7575
Practice Address - Street 1:105 N 3RD ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-8582
Practice Address - Country:US
Practice Address - Phone:318-769-8160
Practice Address - Fax:318-769-8188
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAPIDES HEALTHCARE SYSTEM, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5D047Medicare PIN