COTTONPORT CORNER DRUG LLC (NPI# 1922372358) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922372358 |
| Entity Type | Organization |
| Organization Name | COTTONPORT CORNER DRUG LLC |
| Other Organization Name | COTTONPORT CORNER DRUG LLC |
| Practice Address |
206 Choupique Ln Cottonport LA 71327-3757 |
| Practice Telephone | 3188763665 |
| Practice Fax Number | 3188762429 |
| Mailing Telephone | 3188763665 |
| Mailing Fax Number | 3188762429 |
| Enumeration Date | 2012-03-02 |
| Last Update Date | 2017-04-13 |
| Authorized Official Name | KIM WIXSON (MRS.) |
| Authorized Official Telephone | 3182532399 |
| 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.006498-IR | LA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2134437 | 01 | |
| LA | 2201336 | 05 |
| Other Name | Type Code |
|---|---|
| Cottonport Corner Drug LLC | Doing Business As Name - Organization |
| Street Address |
206 CHOUPIQUE LN |
| City | COTTONPORT |
| State | LA |
| Zip Code | 71327-3757 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306837141 | Eddie's Pharmacy, Inc. | Pharmacy | 206 Choupique Ln, Cottonport, LA 71327-3757 | 2005-11-01 |
| 1528468808 | Kimberly Dupuy Wixson | Pharmacist | 206 Choupique Ln, Cottonport, LA 71327-3757 | 2014-08-24 |
| 1295942084 | Roland Eddie Bordelon | Pharmacist | 206 Choupique Ln, Cottonport, LA 71327-3757 | 2007-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679050728 | Jamie Garrett | Nurse Practitioner | 1007 Sycamore Street, Cottonport, LA 71327 | 2018-07-22 |
| 1811403140 | Joey Lacombe | Behavioral Analyst | 1404 Highway 107, Cottonport, LA 71327 | 2017-12-22 |
| 1093933103 | Newell E. Gauthier, Jr. Md | Clinic/Center | 912 Bryan St., Cottonport, LA 71327 | 2007-04-23 |
| 1568597284 | Marlon L. Holmes | Dentist | 915 North Main St, Cottonport, LA 71327 | 2007-02-22 |
| 1932686086 | Lauren Wiley | Nurse Practitioner | 1007 Sycamore Street, Cottonport, LA 71327 | 2018-07-22 |
| 1326317090 | Marlon L Holmes, Dds A Professional Corporation | Dentist | 915 North Main St., Cottonport, LA 71327 | 2011-12-23 |
| 1316072002 | Antonina B. Holmes | Dentist | 915 North Main St., Cottonport, LA 71327-0655 | 2007-02-22 |
| 1477724995 | Louisiana Health Care Practitioners LLC | Clinic/Center | 1007 Sycamore St Ste B, Cottonport, LA 71327-3403 | 2008-03-13 |
| 1114002698 | Herndon Martin Jeansonne II | Nurse Practitioner | 1007 Sycamore St, Cottonport, LA 71327-3403 | 2006-10-25 |
| 1033735972 | Michelle Gauthier Rozas | Nurse Practitioner | 1007 Sycamore St, Cottonport, LA 71327-3403 | 2020-06-16 |
| Find all providers in zip 71327 | ||||
| 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 |
|---|---|---|---|---|
| 1659432987 | Poret's Thrifty Way Pharmacy, Inc | Pharmacy | 1007 Sycamore St, Suite A, Cottonport, LA 71327-3403 | 2006-12-12 |
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| 1942829247 | Good Vibe Ventures LLC | Pharmacy | 5004 W Esplanade Ave Ste A, Metairie, LA 70006-2551 | 2020-04-16 |
| Find all providers with the same taxonomy | ||||
| City | COTTONPORT |
| Zip Code | 71327 |
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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.