SOUTHERN REGIONAL MEDICAL CORPORATION (NPI# 1639517550) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639517550 |
| Entity Type | Organization |
| Organization Name | SOUTHERN REGIONAL MEDICAL CORPORATION |
| Other Organization Name | LEONARD CHABERT MED CTR OUT PT PHCY |
| Practice Address |
1978 Industrial Blvd Houma LA 70363-7055 |
| Mailing Address |
8166 Main St Houma LA 70360-3404 |
| Practice Telephone | 9858731282 |
| Mailing Telephone | 9858734141 |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2013-08-13 |
| Authorized Official Name | PHYLLIS PEOPLES (PRESIDENT AND CEO) |
| Authorized Official Telephone | 9858734620 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHERN REGIONAL MEDICAL CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1233382 | 05 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 1930379 | 01 |
| Other Name | Type Code |
|---|---|
| Leonard Chabert Med Ctr Out Pt Phcy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326485749 | Southern Regional Medical Corporation | General Acute Care Hospital | 1978 Industrial Blvd, Houma, LA 70363-7055 | 2013-05-24 |
| 1689011280 | Southern Regional Medical Corporation | Psychiatric Unit | 1978 Industrial Blvd, Houma, LA 70363-7055 | 2013-05-23 |
| 1710032495 | Southern Regional Medical Corporation | Pharmacy | 1978 Industrial Blvd, Houma, LA 70363-7055 | 2007-01-24 |
| Street Address |
1978 INDUSTRIAL BLVD |
| City | HOUMA |
| State | LA |
| Zip Code | 70363-7055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841237088 | Leonard J. Chabert Medical Center | General Acute Care Hospital | 1978 Industrial Blvd, Houma, LA 70363-7055 | 2006-05-31 |
| 1215554316 | Rami Hussain | Student in an Organized Health Care Education/Training Program | 1978 Industrial Blvd, Houma, LA 70363 | 2020-07-06 |
| 1518588631 | Stefan Canacevic | Student in an Organized Health Care Education/Training Program | 1978 Industrial Blvd, Houma, LA 70363 | 2020-04-29 |
| 1801415088 | Kellie Lyn Lucas | Student in an Organized Health Care Education/Training Program | 1978 Industrial Blvd, Houma, LA 70363-7055 | 2020-04-08 |
| 1467081364 | Priyanka Sanjeev Patel | Student in an Organized Health Care Education/Training Program | 1978 Industrial Blvd, Houma, LA 70363-7055 | 2020-04-03 |
| 1871122739 | Seth Haydel | Student in an Organized Health Care Education/Training Program | 1978 Industrial Blvd, Houma, LA 70363-7055 | 2020-04-03 |
| 1285263277 | Sofia Beg | Student in an Organized Health Care Education/Training Program | 1978 Industrial Blvd, Houma, LA 70363-7055 | 2020-04-02 |
| 1871129916 | Anna Catherine Waguespack | Nurse Anesthetist, Certified Registered | 1978 Industrial Blvd, Houma, LA 70363-7055 | 2020-03-20 |
| 1124660345 | Renee St Germain | Nurse Practitioner | 1978 Industrial Blvd, Houma, LA 70363-7055 | 2019-10-09 |
| 1780245829 | Oluwatoyin Opeyemi Alawale | Student in an Organized Health Care Education/Training Program | 1978 Industrial Blvd, Houma, LA 70363 | 2019-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588286991 | Nadish Ravindran | Student in an Organized Health Care Education/Training Program | 1978 Industrial Blvd Internal Medicine Program, Chabert Medical Center, Houma, LA 70363 | 2020-05-08 |
| 1912527185 | Gurjit Singh Brar | Student in an Organized Health Care Education/Training Program | Chabert Medical Center 1978 Industrial Blvd, Internal Medicine Residency Program, Houma, LA 70363 | 2020-04-17 |
| 1912568718 | Blake P Pitre | Pharmacist | 13087 West Main St, Larose, LA 70363 | 2019-06-24 |
| 1528623212 | Navkiran Singh Jagdev | Student in an Organized Health Care Education/Training Program | 1978 Industrial Blvd Chabert Medical Center, Internal Medicine Residency Program, Houma, LA 70363 | 2019-05-08 |
| 1376107367 | Sheahahn Vikash Soundranayagam | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency Program Chabert Medical, Center, 1978 Industrial Blvd, Hourna, LA 70363 | 2019-04-25 |
| 1962991034 | Naveen Silva | Student in an Organized Health Care Education/Training Program | 1976 Industrial Blvd, Internal Medicine Residency Program Chabert Medical Cen, Houma, LA 70363 | 2018-05-04 |
| 1841647526 | Ammad Asad Syed | Student in an Organized Health Care Education/Training Program | 1978 Industrial Blvd., Internal Medicine Residency Program, Chabert Medical Ce, Houma, LA 70363 | 2016-05-23 |
| 1538514450 | Khizran Rizvi | Internal Medicine | 1978 Industrial Blvd. Chabert Medical Center, Internal Medicine Residency Program, Houma, LA 70363 | 2016-04-28 |
| 1649656836 | David Price | Pharmacist | 9303 East Parke Avenue, Houma, LA 70363 | 2015-08-11 |
| 1346638053 | Donna Marie Neville | Case Manager/Care Coordinator | 137 New Orleans Blvd, Houma, LA 70363 | 2015-01-05 |
| Find all providers in zip 70363 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194187591 | St. Vincent De Paul Tri Parish Pharmacy | Pharmacy | 7385 Main St, Houma, LA 70360-4021 | 2016-03-24 |
| 1801210935 | Peoples Drug Store | Pharmacy | 7869 Main Street, Houma, LA 70360 | 2014-02-10 |
| 1548564677 | March Willows | Pharmacy | 2138 Bayou Blue Rd, Houma, LA 70364-3909 | 2011-01-04 |
| 1518092436 | Peoples Drug Store Inc | Pharmacy | 101 Goode St, Houma, LA 70360-4443 | 2007-02-22 |
| 1417026360 | Broadmoor Drug Center Inc | Pharmacy | 6096 W Park Ave, Houma, LA 70364-1808 | 2006-11-07 |
| 1629172689 | Haydels Drug Store Inc | Pharmacy | 4752 Highway 311 Ste 100, Houma, LA 70360-2810 | 2006-09-12 |
| 1104930189 | Haydels Drug Store Inc | Pharmacy | 831 Grand Caillou Rd, Houma, LA 70363-5882 | 2006-08-18 |
| 1366939613 | Peoples Drug Store | Pharmacy | 7869 Main St, Houma, LA 70360-4461 | 2018-04-21 |
| 1760686869 | Houma Family Drugs | Pharmacy | 606 Liberty St, Suite A, Houma, LA 70360-4622 | 2007-06-13 |
| 1710032495 | Southern Regional Medical Corporation | Pharmacy | 1978 Industrial Blvd, Houma, LA 70363-7055 | 2007-01-24 |
| Find all providers in HOUMA | ||||
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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.