Organization Name: | NORTHEAST LOUISIANA PHARMACY |
NPI Number: | 1659696730 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DOUGLAS E. ROBICHAUS (MANAGING MEMBER) |
Mailing Address: | 8860 Quimper Pl Suite 100 Shreveport |
State: | LA US |
Postal Code: | 711055686 |
Phone Number: | 3187979517 |
Fax Number: | 3182120057 |
NPI Enumeration Date: | 04/01/2010 |
NPI Last Update Date: | 04/01/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |