CLINIC PHARMACY OF MANGHAM LLC (NPI# 1871553453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871553453 |
| Entity Type | Organization |
| Organization Name | CLINIC PHARMACY OF MANGHAM LLC |
| Other Organization Name | CLINIC PHARMACY OF MANGHAM LLC |
| Practice Address |
252 Highway 132 Mangham LA 71259-5268 |
| Practice Telephone | 3182483338 |
| Practice Fax Number | 3182483399 |
| Mailing Telephone | 3182483338 |
| Mailing Fax Number | 3182483399 |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2016-03-03 |
| Authorized Official Name | KAYLA BRIDGES (OWNER/AO) |
| Authorized Official Telephone | 3182483338 |
| Authorized Official Credential | PD |
| 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.006681-IR | LA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2202081 | 05 | |
| PK | 2035210 | 01 |
| Other Name | Type Code |
|---|---|
| CLINIC PHARMACY OF MANGHAM LLC | Doing Business As Name - Organization |
| Street Address |
252 HIGHWAY 132 |
| City | MANGHAM |
| State | LA |
| Zip Code | 71259-5268 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528028131 | Karen Michelle Seffens | Pharmacy Technician | 252 Highway 132, Mangham, LA 71259-5268 | 2006-03-27 |
| 1457752701 | Andrea Spruell | Pharmacist | 252 Highway 132, Mangham, LA 71259-5268 | 2014-09-05 |
| 1992766182 | Kayla D Bridges | Pharmacist | 252 Highway 132, Mangham, LA 71259-5268 | 2006-03-29 |
| 1174584379 | Rebecca Ann Hill | Pharmacy Technician | 252 Highway 132, Mangham, LA 71259-5268 | 2006-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366610719 | Mangham Home Care | Home Health | 714 Broadway Street, Mangham, LA 71259 | 2008-02-19 |
| 1386754620 | Jennifer Newton Boles | Dentist | 4279 Hwy 15, Mangham, LA 71259 | 2006-08-30 |
| 1720006679 | Mangham Home Care Inc | Home Health | 714 Broadway, Mangham, LA 71259 | 2006-07-18 |
| 1700841079 | Mangham Rx Drugs, Inc | Pharmacy | 104 Louisiana St, Mangham, LA 71259 | 2006-04-19 |
| 1972767291 | Mangham Home Care, Inc. | Home Health | 714 Broadway Street, Mangham, LA 71259 | 2008-07-16 |
| 1538235429 | Mangham Home Care, Inc | Home Health | 714 Broadway, Mangham, LA 71259 | 2006-11-24 |
| 1902850035 | Affinity Health Group, LLC | Family Medicine | 261 Hwy 132, Mangham, LA 71259-0219 | 2006-05-22 |
| 1578665477 | Community Care Services, Inc. | Technician | 508 Horace St, Mangham, LA 71259-5056 | 2006-09-01 |
| 1154450641 | Community Care Services, Inc | Technician | 508 Horace St, Mangham, LA 71259-5056 | 2007-03-02 |
| 1043347206 | Community Care Services, Inc | Technician | 508 Horace St, Mangham, LA 71259-5056 | 2007-02-27 |
| Find all providers in zip 71259 | ||||
| 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 |
|---|---|---|---|---|
| 1700841079 | Mangham Rx Drugs, Inc | Pharmacy | 104 Louisiana St, Mangham, LA 71259 | 2006-04-19 |
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| 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.