MR. KENNETH W BOUDREAUX (NPI# 1629384003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629384003 |
| Entity Type | Individual |
| Full Name | MR. KENNETH W BOUDREAUX |
| Credential | R.PH. |
| Practice Address |
3400 Military Hwy Pineville LA 71360 |
| Mailing Address |
38 Hammack Ln Ball LA 71405-3261 |
| Practice Telephone | 3186408066 |
| Mailing Telephone | 3186404448 |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2010-08-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 10753 | LA | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1896781 | 05 |
| Street Address |
3400 MILITARY HWY |
| City | PINEVILLE |
| State | LA |
| Zip Code | 71360 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881609063 | Walgreen Co | Pharmacy | 3400 Military Hwy, Pineville, LA 71360-4230 | 2006-07-29 |
| 1124479621 | Rhonda Shearin | Pharmacist | 3400 Military Hwy, Pineville, LA 71360-4230 | 2016-06-26 |
| 1194182394 | Ignatius Nnamdi Anierobi | Pharmacist | 3400 Military Hwy, Pineville, LA 71360-4230 | 2016-01-20 |
| 1649553686 | Hillee Salley | Pharmacist | 3400 Military Hwy, Pineville, LA 71360-4230 | 2011-09-26 |
| 1578774709 | Michele Ann Deshotel-saucier | Pharmacist | 3400 Military Hwy, Pineville, LA 71360-4231 | 2007-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578110789 | Reneisha Armonii Roberts | Pharmacist | 3100 La-28, Pineville, LA 71360 | 2019-08-22 |
| 1396303145 | Tina Marie Lawhorn | Nurse Practitioner | 2945 Shreveport Hwy, Pineville, LA 71360 | 2019-06-05 |
| 1942773213 | Tioga Pharmacy LLC | Pharmacy | 5101 Shreveport Hwy, Pineville, LA 71360 | 2019-01-09 |
| 1649755497 | Jessica Wooten | Nurse Practitioner | 292 Jerry Lofton Rd, Pineville, LA 71360 | 2018-09-27 |
| 1215421995 | Elizabeth Simon-clark | Counselor | Central La State Hospital Unit 6 Meadows Lane, Pineville, LA 71360 | 2018-06-18 |
| 1982116497 | Dm Properties of Rapides, LLC | Radiology | 2705 Highway 28 E Ste B, Pineville, LA 71360 | 2017-10-25 |
| 1508384587 | Marion Patrick Hazelton I | Counselor | Pathways Red River Treatment Center, 242 West Shamrock Ave Unit 6 Melody Lane, Pineville, LA 71360 | 2017-08-30 |
| 1669902557 | Jessica Williams | Social Worker | Unit 6 Wing A Meadow Lane, Pineville, LA 71360 | 2017-06-14 |
| 1104365840 | Naomi Gates | Social Worker | 242 W Shamrock Unit 1, Pineville, LA 71360 | 2017-02-14 |
| 1861930224 | Sharon Humphrey | Counselor | 5400 Service Rd B206, Pineville, LA 71360 | 2017-02-06 |
| Find all providers in zip 71360 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871191718 | Cody Stewart | Pharmacist | 906 Dorton Branch Rd, Pineville, KY 40977-9287 | 2020-10-13 |
| 1578110789 | Reneisha Armonii Roberts | Pharmacist | 3100 La-28, Pineville, LA 71360 | 2019-08-22 |
| 1477926103 | Edward Scalfano | Pharmacist | 242 W Shamrock Ave Unit 2, Room 120, Pineville, LA 71360-6439 | 2015-11-03 |
| 1497155071 | Kellie Williams | Pharmacist | 2350 Donahue Ferry Rd, Pineville, LA 71360-4457 | 2014-09-02 |
| 1821423336 | Jeffrey S Lima | Pharmacist | 116 N Pine St, Pineville, KY 40977-1647 | 2013-09-04 |
| 1013359389 | Barry Jon Sylvester | Pharmacist | 100 Edgewood Dr., Pineville, LA 71360 | 2013-07-26 |
| 1467700690 | Leo Gerard Riche | Pharmacist | 131 Hidden Path Dr, Pineville, LA 71360-2202 | 2012-08-20 |
| 1053695627 | Shelia Marie Key | Pharmacist | 528 W Tenn Ave, Pineville, KY 40977-1437 | 2011-09-30 |
| 1871876813 | Timothy Brent Lasley II | Pharmacist | 4106 Highway 987 Laurel Hl, Pineville, KY 40977-8381 | 2011-09-26 |
| 1467733055 | Merek Marcantel | Pharmacist | 4828 Shreveport Hwy, Pineville, LA 71360-3835 | 2011-09-08 |
| Find all providers in PINEVILLE | ||||
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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.