1235183864 NPI number — REGIONAL HEALTH SERVICES LLC

Table of content: (NPI 1235183864)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235183864 NPI number — REGIONAL HEALTH SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REGIONAL HEALTH SERVICES LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
REGIONAL MEDICAL RENTAL & SALES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235183864
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/29/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3003 N MACARTHUR DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALEXANDRIA
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71303-4143
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-449-4510
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
121 COURT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW ROADS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70760-3615
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-638-3268
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FABRE
Authorized Official First Name:
RANDALL
Authorized Official Middle Name:
CHARLES
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
225-629-3000

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  3229036-005 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BC3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BN1400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BP3500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1540919 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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