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General NPI Number Information
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NPI Number | 1518648153
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Entity Type | Individual
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Provider Name | MRS. PASCOL RIDEAU
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Gender | Female
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Dates
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Enumeration Date | 07/27/2023
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 270 COMPRESS RD
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City | OPELOUSAS
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State | LA
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Zip | 70570-1136
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Country | US
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Telephone | 337-308-6242
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Fax | 866-846-7114
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Provider Business Mailing Address
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Address Line | PO BOX 456
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City | WASHINGTON
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State | LA
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Zip | 70589-0456
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Country | US
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Telephone | 337-308-6242
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Fax | 866-846-7114
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number | 328495
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License Number State | LA
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