Organization
LOUISIANA REHAB PRODUCTS INC
Active
Parent organization
LOUISISNA REHAB PRODUCTS INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOUISISNA REHAB PRODUCTS INC
Authorized official
MR. RICKY WALTER DECASTRO SR. (PRESIDENT)
(504) 468-6100
Entity
Organization
Contact information
Practice address
11135 INDUSTRIPLEX BLVD, STE 810, BATON ROUGE, LA 70809-4114
(225) 751-9339
(225) 751-2751
Mailing address
2424 WILLIAMS BLVD, STE C, KENNER, LA 70062-5763
(504) 468-6100
(504) 468-6109
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
LA
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1998214
—
LA
01
—
77610
BCBS OF LOUISIANA
LA
Enumeration date
01/17/2013
Last updated
01/17/2013
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