LOUISIANA CVS PHARMACY LLC (NPI# 1902176142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902176142 |
| Entity Type | Organization |
| Organization Name | LOUISIANA CVS PHARMACY LLC |
| Other Organization Name | CVS PHARMACY #04743 |
| Practice Address |
9510 Ellerbe Rd Shreveport LA 71106-7406 |
| Mailing Address |
1 Cvs Dr Box 1075 - Pharmacy Enrollments Woonsocket RI 02895-6146 |
| Practice Telephone | 3187973272 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2012-01-05 |
| Last Update Date | 2018-04-17 |
| Authorized Official Name | SUSAN F COLBERT (DIRECTOR PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP | 1936016 | 01 | |
| DEA | FL3055197 | 01 | |
| LA | 2201271 | 05 | |
| LA | PHARMACY STATE LICENSE | PHY006485RC | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #04743 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053801415 | Louisiana Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1420 Saint Charles St, Houma, LA 70360 | 2018-05-11 |
| 1619334703 | Louisiana Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 5000 North Claiborne Ave., New Orleans, LA 70117-4705 | 2016-01-21 |
| 1407211717 | Louisiana Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 500 N Carrollton Ave # 1, New Orleans, LA 70119-4705 | 2015-12-31 |
| 1629447594 | Louisiana Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1116 Louisiana Ave, New Orleans, LA 70115-2454 | 2015-09-21 |
| 1972983732 | Louisiana Cvs Pharmacy LLC | Pharmacy | 1204 Elton Rd, Jennings, LA 70546-4136 | 2015-06-05 |
| 1588044648 | Louisiana Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 939 Girod St, Suite 160, New Orleans, LA 70113-0000 | 2015-06-04 |
| 1073919635 | Louisiana Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1600 Elysian Fields Ave, New Orleans, LA 70117-8209 | 2014-11-10 |
| 1699180018 | Louisiana Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 20501 Old Scenic Highway, Zachary, LA 70791 | 2014-06-24 |
| 1740606763 | Louisiana Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 9326 Burbank Dr, Baton Rouge, LA 70820 | 2014-03-14 |
| 1548684293 | Louisiana Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 800 Brownswitch Rd, Slidell, LA 70458-5334 | 2014-02-14 |
| Street Address |
9510 ELLERBE RD |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71106-7406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891293890 | Emmanuel Abodoh | Pharmacist | 9510 Ellerbe Rd, Shreveport, LA 71106-7406 | 2018-01-25 |
| 1437673951 | Anthony Leonard Jenkins | Pharmacist | 9510 Ellerbe Rd, Shreveport, LA 71106-7406 | 2017-07-26 |
| 1225408727 | Joseph Jowers | Pharmacist | 9510 Ellerbe Rd, Shreveport, LA 71106-7406 | 2015-09-28 |
| 1518343086 | Nilay A. Patel | Pharmacist | 9510 Ellerbe Rd, Shreveport, LA 71106-7406 | 2015-08-06 |
| 1629314232 | Audrey J Breaux | Pharmacist | 9510 Ellerbe Rd, Shreveport, LA 71106-7406 | 2012-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972008332 | Andrew Joseph Brouillette | Dentist | 385 Bert Kouns Industrial Loop Ste 700, Shreveport, LA 71106 | 2018-03-28 |
| 1548775885 | David Wayne Spears | Pharmacist | 10460 Norris Ferry Road, Shreveport, LA 71106 | 2017-12-08 |
| 1225559263 | Susan Anderson Roblow | Physical Therapist | 921 Unadilla Street, Shreveport, LA 71106 | 2017-06-29 |
| 1134656382 | James Lowder | Dentist | 8691 Line Ave Ste 300, Shreveport, LA 71106 | 2017-05-18 |
| 1144753708 | Laverne Brantley | Counselor | 328 E 69th St, Shreveport, LA 71106 | 2017-04-10 |
| 1437690849 | Biostat Laboratories, LLC | Clinical Medical Laboratory | 9742 Saint Vincent Ave Ste 200, Shreveport, LA 71106 | 2017-03-17 |
| 1841730728 | Cedric Thomas | Case Manager/Care Coordinator | 6811 Fairfield Avenue, Shreveport, LA 71106 | 2017-02-27 |
| 1225576192 | Nick Vergis | Pharmacist | 5828 Line Avenue, Shreveport, LA 71106 | 2017-02-10 |
| 1184162554 | Marilyn Johnson | Case Manager/Care Coordinator | 9245 Wallace Lake Rd Ste A, Shreveport, LA 71106 | 2017-02-06 |
| 1417499740 | Pamela Lee | Counselor | 8802 Coyth Ln, Shreveport, LA 71106 | 2016-11-17 |
| Find all providers in zip 71106 | ||||
| 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 |
|---|---|---|---|---|
| 1588036552 | Brfhh Shreveport LLC | Pharmacy | 1541 Kings Hwy Rm Eg-10, Shreveport, LA 71103-4228 | 2015-10-29 |
| 1982962890 | Jewella Avenue Pharmacy | Pharmacy | 3610 Jewella Ave, Suite B, Shreveport, LA 71109-4700 | 2012-04-27 |
| 1265675029 | Martin Luther King Health Center | Pharmacy | 1233 Sprague St., Shreveport, LA 71101 | 2009-04-09 |
| 1134272644 | Pill Box Pharmacy Incorporated | Pharmacy | 1849 Line Ave, Shreveport, LA 71101-4611 | 2007-01-19 |
| 1114090446 | Brookshire Grocery Company | Pharmacy | 388 Bert Kouns Loop, Attention Pharmacy Dept, Shreveport, LA 71106-8123 | 2006-11-16 |
| 1952474421 | Brookshire Grocery Company | Pharmacy | 3620 Pines Rd, Attention Pharmacy Dept, Shreveport, LA 71119-5206 | 2006-11-15 |
| 1861565335 | Brookshire Grocery Company | Pharmacy | 510 Kings Hwy, Attention Pharmacy Dept, Shreveport, LA 71104-4444 | 2006-11-15 |
| 1316010887 | Brookshire Grocery Company | Pharmacy | 5828 Line Ave, Attention Pharmacy Dept, Shreveport, LA 71106-1532 | 2006-11-15 |
| 1225101793 | Brookshire Grocery Company | Pharmacy | 3000 N Market St, Attention Pharmacy Dept, Shreveport, LA 71107-4062 | 2006-11-15 |
| 1780757252 | Brookshire Grocery Company | Pharmacy | 2640 Waggoner Ave, Attention Pharmacy Dept, Shreveport, LA 71108-3859 | 2006-11-15 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71106 |
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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.