Provider Demographics
NPI:1952017287
Name:PROSXYSRX-LA LLC
Entity Type:Organization
Organization Name:PROSXYSRX-LA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:CALHOUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-533-9119
Mailing Address - Street 1:1500 URBAN CENTER DR STE 325
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2205
Mailing Address - Country:US
Mailing Address - Phone:205-533-9119
Mailing Address - Fax:
Practice Address - Street 1:8120 MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-3403
Practice Address - Country:US
Practice Address - Phone:985-333-2433
Practice Address - Fax:985-333-2434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy