Provider Demographics
NPI:1649348889
Name:OPIERX, INC
Entity type:Organization
Organization Name:OPIERX, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NUNNELEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-574-6363
Mailing Address - Street 1:501 N CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:TALLULAH
Mailing Address - State:LA
Mailing Address - Zip Code:71282-3507
Mailing Address - Country:US
Mailing Address - Phone:318-574-6363
Mailing Address - Fax:318-574-9315
Practice Address - Street 1:501 N CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:TALLULAH
Practice Address - State:LA
Practice Address - Zip Code:71282-3507
Practice Address - Country:US
Practice Address - Phone:318-574-6363
Practice Address - Fax:318-574-9315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
LAPHY.006147-IR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1235261Medicaid
2121925OtherPK
2121925OtherPK