Organization
LOUISIANA REHAB PRODUCTS, INC.
Active
Parent organization
LOUISIANA REHAB PRODUCTS, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOUISIANA REHAB PRODUCTS, INC.
Authorized official
MR. RICKY DECASTRO SR. (PRESIDENT)
(504) 468-6100
Entity
Organization
Contact information
Practice address
7030 CANAL BLVD, SUITE 120, NEW ORLEANS, LA 70124-3410
(504) 468-6100
(504) 468-6109
Mailing address
2424 WILLIAMS BLVD, SUITE C, KENNER, LA 70062-5763
(504) 468-6100
(504) 468-6109
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1998214
—
LA
01
—
77610
BCBS OF LOUISIANA
LA
Enumeration date
07/27/2016
Last updated
07/27/2016
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