Organization
ROSEPHINE FAMILY PHARMACY, INC
Active
Other names
ROSEPHINE FAMILY VITAL CARE
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW DALE PETERSON (MANAGER)
(337) 462-0177
Entity
Organization
Contact information
Practice address
18507 CENTRAL AVE, ROSEPHINE, LA 70659
(337) 462-0177
(337) 462-0078
Mailing address
PO BOX 5047, MERIDIAN, MS 39302-5047
(800) 447-4095
(601) 482-7490
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
20000-IR
LA
332BC3200X
Customized Equipment (DME)
20000-IR
LA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
20000-IR
LA
332BX2000X
Oxygen Equipment & Supplies (DME)
20000-IR
LA
333600000X
Pharmacy
20000-IR
LA
3336C0003X
Community/Retail Pharmacy
20000-IR
LA
3336H0001X
Home Infusion Therapy Pharmacy
20000-IR
LA
3336L0003X
Long Term Care Pharmacy
20000-IR
LA
3336M0002X
Mail Order Pharmacy
20000-IR
LA
3336S0011X
Specialty Pharmacy
Primary
20000-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1256340
—
LA
05
—
599232
—
TX
Enumeration date
09/05/2006
Last updated
09/11/2025
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