TAILOR ILISE RILEY (NPI# 1841771995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841771995 |
| Entity Type | Individual |
| Full Name | TAILOR ILISE RILEY |
| Credential | PHARMD |
| Practice Address |
2010 Country Club Rd Lake Charles LA 70605-5206 |
| Mailing Address |
168 Allen Marcantel Rd Kinder LA 70648-5438 |
| Practice Telephone | 3379904902 |
| Mailing Telephone | 3374965451 |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2018-08-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
PST.022506 | LA | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | LOUISIANA BOARD OF PHARMACY | MA.003770 | 01 |
| LA | LOUISIANA BOARD OF PHARMACY | PST.022506 | 01 |
| Street Address |
2010 COUNTRY CLUB RD |
| City | LAKE CHARLES |
| State | LA |
| Zip Code | 70605-5206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932647179 | Kroger Co | Durable Medical Equipment & Medical Supplies | 2010 Country Club Rd, Lake Charles, LA 70605-5206 | 2017-02-08 |
| 1083224729 | Kendrick Charles Wilkins | Pharmacist | 2010 Country Club Rd, Lake Charles, LA 70605-5206 | 2020-08-07 |
| 1336705235 | Anita Rahman | Pharmacist | 2010 Country Club Rd, Lake Charles, LA 70605-5206 | 2019-05-15 |
| 1598283277 | Katelyn Thomas | Pharmacist | 2010 Country Club Rd, Lake Charles, LA 70605-5206 | 2017-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780283606 | Kristin R Morris | Clinical Nurse Specialist | 1900 W. Gaythier Rd, Lake Charles, LA 70605 | 2020-10-21 |
| 1548871577 | Jacob M Theriot | Nurse Practitioner | 2640 County Club Rd., Lake Charles, LA 70605 | 2020-08-13 |
| 1053898403 | Heather Spallino Duplechain | Nurse Practitioner | 6713 Nelson Rd., Lake Charles, LA 70605 | 2018-07-27 |
| 1578057956 | Noor Deeb Weckerly | Nurse Practitioner | 6713 Nelson Rd, Lake Charles, LA 70605 | 2018-06-19 |
| 1861993354 | Therapy Works of Swla LLC | Physical Therapist | 4750 Lake Street, Lake Charles, LA 70605 | 2018-02-21 |
| 1669998852 | Amd Healthcare Lc, LLC | General Acute Care Hospital | 3730 Nelson Road, Lake Charles, LA 70605 | 2017-08-18 |
| 1619422474 | Kaitlyn Pinkerton | Specialist/Technologist | 800 E Mcneese St, Lake Charles, LA 70605 | 2016-08-22 |
| 1104274679 | Kelly Rogers | Counselor | 90 N. Luke 102l, Lafayette, LA 70605 | 2016-05-25 |
| 1548616220 | Lisa Monticello Snider | Neurological Surgery | 3297 Portrush Drive, Lake Charles, LA 70605 | 2016-05-11 |
| 1114387404 | Louisiana Dental Professionals, Donovan Dronet, Dds, A Professional De | Dentist | 4459 Nelson Rd, Suite 120, Lake Charles, LA 70605 | 2016-02-29 |
| Find all providers in zip 70605 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700169463 | Leslie Richard Carr | Pharmacist | 5840 Brookflower Circle Ln, Lake Charles, LA 70605-0293 | 2011-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952957557 | Medication Management Consultants LLC | Pharmacist | 318 Bevly Lake Dr, Bossier City, LA 71111-5174 | 2019-08-11 |
| 1801395108 | Pharmdready, LLC | Pharmacist | 1921 Oak Creek Rd Apt 237, River Ridge, LA 70123-5870 | 2018-02-02 |
| 1609241587 | Wagih Sous | Pharmacist | 4283 Carter St., Vidalia, LA 71373 | 2015-12-03 |
| 1790158426 | Kady Eschete | Pharmacist | 114 Bayou Bend Dr, Houma, LA 70364-1101 | 2015-11-03 |
| 1760874135 | John Scott Blake | Pharmacist | 624 Texas St Apt 403, Shreveport, LA 71101-3553 | 2015-02-23 |
| 1811397656 | Walmart Pharmacy | Pharmacist | 8912 Veterans Blvd, Metairie, LA 70003 | 2014-08-29 |
| 1700285855 | Sam Grizzaffi | Pharmacist | 3224 Lake Palourde Dr, Morgan City, LA 70380-1563 | 2014-08-14 |
| 1992080741 | John Michael Pollard | Pharmacist | 8155 Highway 165, Columbia, LA 71418-4341 | 2011-10-12 |
| 1700175734 | Timothy James Moten | Pharmacist | 114 Gause, Slidell, LA 70460 | 2011-03-30 |
| 1417256942 | Cody Allison | Pharmacist | 115 Glenwood Dr, Metairie, LA 70005-3911 | 2011-03-23 |
| Find all providers with the same taxonomy | ||||
| City | LAKE CHARLES |
| Zip Code | 70605 |
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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.