Provider Demographics
NPI:1053578955
Name:RX CARE HOSPITAL DIVISION, INC.
Entity type:Organization
Organization Name:RX CARE HOSPITAL DIVISION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAPAHEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MECHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-334-9979
Mailing Address - Street 1:915 THE BLVD
Mailing Address - Street 2:P.O. DRAWER 578
Mailing Address - City:RAYNE
Mailing Address - State:LA
Mailing Address - Zip Code:70578-6134
Mailing Address - Country:US
Mailing Address - Phone:337-334-9979
Mailing Address - Fax:
Practice Address - Street 1:915 THE BLVD
Practice Address - Street 2:P.O. DRAWER 578
Practice Address - City:RAYNE
Practice Address - State:LA
Practice Address - Zip Code:70578-6134
Practice Address - Country:US
Practice Address - Phone:337-334-9979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5107-IR333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1270873Medicaid