Provider Demographics
NPI:1932264363
Name:FRANCISCAN MISSIONARIES OF OUR LADY HEALTH SYSTEM INC
Entity Type:Organization
Organization Name:FRANCISCAN MISSIONARIES OF OUR LADY HEALTH SYSTEM INC
Other - Org Name:RXONE MED PLAZA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP, CMO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:GREMILLION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-765-8724
Mailing Address - Street 1:7777 HENNESSY BLVD
Mailing Address - Street 2:STE 114
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4300
Mailing Address - Country:US
Mailing Address - Phone:225-765-8140
Mailing Address - Fax:225-765-3472
Practice Address - Street 1:7777 HENNESSY BLVD
Practice Address - Street 2:STE 114
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4300
Practice Address - Country:US
Practice Address - Phone:225-765-8951
Practice Address - Fax:225-765-3472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X, 3336L0003X, 3336C0004X
LAPHY.007557IR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2032255OtherPK
LA2205676Medicaid