WILLOW MINA (NPI# 1235689977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235689977 |
| Entity Type | Organization |
| Organization Name | WILLOW MINA |
| Other Organization Name | WILLOW BARK PHARMACY |
| Practice Address |
606 Highway 20 Thibodaux LA 70301-6255 |
| Practice Telephone | 9856332275 |
| Practice Fax Number | 9856334703 |
| Mailing Telephone | 9856332275 |
| Mailing Fax Number | 9856334703 |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2017-02-14 |
| Authorized Official Name | MINH NGUYEN (PRESIDENT) |
| Authorized Official Telephone | 9857724088 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY.007400-IR | LA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2166319 | 01 | |
| LA | 2204882 | 05 |
| Other Name | Type Code |
|---|---|
| WILLOW BARK PHARMACY | Doing Business As Name - Organization |
| Street Address |
606 HIGHWAY 20 |
| City | THIBODAUX |
| State | LA |
| Zip Code | 70301-6255 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225539620 | Micah Aaron Callais | Nurse Practitioner | 604 N. Acadia Road, Suite 200, Thibodaux, LA 70301 | 2018-02-22 |
| 1982112348 | Katie Leblanc | Massage Therapist | 1115 St. Mary Street, Thibodaux, LA 70301 | 2018-01-18 |
| 1154837391 | Texas Digestive Disease Consultants, Pllc | Internal Medicine | 764 North Acadia Road, Suite A, Thibodaux, LA 70301 | 2017-12-26 |
| 1235648239 | Speech and Feeding Therapy, LLC | Speech-Language Pathologist | 1000 Plantation Rd Ste 1a, Thibodaux, LA 70301 | 2017-09-22 |
| 1285150466 | Tara Payne | Counselor | 303 Hickory Street, Thibodaux, LA 70301 | 2017-08-18 |
| 1427583475 | Tyler Pettigrew | Counselor | 300 Plantation Rd., Apt #24, Thibodaux, LA 70301 | 2017-04-27 |
| 1750825758 | Jessica Barquet | Counselor | 110 Palm Villa Dr Apt 1, Thibodaux, LA 70301 | 2016-12-09 |
| 1013468230 | Shenee Haas Gros | Counselor | 504 Cherry St., Thibodaux, LA 70301 | 2016-10-24 |
| 1982155388 | Southern Ent Associates Inc | Audiologist | 604 North Acadia Road Suite 101, Thibodaux, LA 70301 | 2016-10-20 |
| 1215483888 | Lesheeca Norman, Lpc | Counselor | 306 Victoria Court, Thibodaux, LA 70301 | 2016-09-01 |
| Find all providers in zip 70301 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518568054 | Chris Pharmacy of Gonzalez LLC | Pharmacy | 14505 Highway 44 Ste 112, Gonzales, LA 70737-7195 | 2020-11-02 |
| 1639779788 | Harvey Lee Smith Jr. | Pharmacy | 1707 Gardere Ln Ste F, Baton Rouge, LA 70820-8144 | 2020-10-28 |
| 1194331579 | Minden Family Pharmacy LLC | Pharmacy | 120 Homer Rd, Minden, LA 71055 | 2020-09-21 |
| 1093321812 | Community Pharmacy of Sterlington | Pharmacy | 200 Scott Dr, Sterlington, LA 71280 | 2020-09-17 |
| 1386256121 | Lagniappe Pharmacy 7, LLC | Pharmacy | 1900 Saint Charles Ave, New Orleans, LA 70130-5317 | 2020-08-22 |
| 1740890144 | Downtown Drugs Inc | Pharmacy | 338 N Vermont St, Covington, LA 70433-2812 | 2020-07-31 |
| 1053929703 | Viallon Drug Co of Donaldsonville | Pharmacy | 309 Marchand Dr, Donaldsonville, LA 70346-3242 | 2020-07-20 |
| 1619595584 | Brown's Pharmacy, LLC | Pharmacy | 1718 North Foster Drive, Suite B, Baton Rouge, LA 70806 | 2020-07-08 |
| 1417573593 | Doc Your Dose Pharmacy, LLC | Pharmacy | 17275 Hwy 77, Gross Tete, LA 70740 | 2020-06-24 |
| 1942829247 | Good Vibe Ventures LLC | Pharmacy | 5004 W Esplanade Ave Ste A, Metairie, LA 70006-2551 | 2020-04-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.