MEDICARE: LOUISIANA REHAB PRODUCTS, INC.

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	335E00000X	Prosthetic/Orthotic Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	77610	OTHER	LA	BCBS OF LOUISIANA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902359870
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOUISIANA REHAB PRODUCTS, INC.

Provider Business Mailing Address
First Line	:	2424 WILLIAMS BLVD
Second Line	:	SUITE C
City	:	KENNER
State	:	LA
Zip	:	70062-5763
Country	:	US
Telephone Number	:	504-468-6100
Fax Number	:	504-468-6109

Provider Business Practice Location Address
First Line	:	7030 CANAL BLVD
Second Line	:	SUITE 120
City	:	NEW ORLEANS
State	:	LA
Zip	:	70124-3410
Country	:	US
Telephone Number	:	504-468-6100
Fax Number	:	504-468-6109

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RICKY DECASTRO SR.
Credential	:
Telephone Number	:	504-468-6100

Provider Enumeration Date	:	07/27/2016
Last Update Date	:	07/27/2016

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Directions to “LOUISIANA REHAB PRODUCTS, INC. ” Practice Location

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