MEDICARE: R A HOLDINGS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	023298	LA
2	363LF0000X	Family Nurse Practitioner	AP04774	LA
3	207R00000X	Internal Medicine Physician	023298	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548420540
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R A HOLDINGS LLC

Provider Business Mailing Address
First Line	:	PO BOX 15271
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70895-5271
Country	:	US
Telephone Number	:	225-922-8377
Fax Number	:	225-930-0260

Provider Business Practice Location Address
First Line	:	8894 AIRLINE HWY
Second Line	:	SUITE Q
City	:	BATON ROUGE
State	:	LA
Zip	:	70815-4081
Country	:	US
Telephone Number	:	225-922-8377
Fax Number	:	225-930-0260

Authorized Official
Title or Position	:	PHYSICIAN OWNER
Name	:	DR. RONALD ANDREWS
Credential	:	M.D.
Telephone Number	:	225-922-8377

Provider Enumeration Date	:	06/12/2008
Last Update Date	:	06/12/2008

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Directions to “R A HOLDINGS LLC ” Practice Location

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