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General NPI Number Information
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NPI Number | 1871632737
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Entity Type | Organization
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Legal Business Name | RESPACARE OF LOUISIANA LLC
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 12/16/2008
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Provider Practice Location Address
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Address Line | 6941 HIGHWAY 11 STE A-3
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City | CARRIERE
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State | MS
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Zip | 39426-7793
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Country | US
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Telephone | 888-460-9933
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Fax | 985-652-9530
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Provider Business Mailing Address
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Address Line | 719 W 5TH ST
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City | LA PLACE
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State | LA
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Zip | 70068-5504
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Country | US
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Telephone | 985-652-9933
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Fax | 985-652-9530
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. CAROL S VAZQUEZ
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Credential | RESPIRATORY THERAPIS
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Telephone | 985-652-9933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | 0569202.5
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License Number State | MS
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