Healthcare Provider Details

I. General information

NPI: 1538174156
Provider Name (Legal Business Name): ALBANY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 03/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19089 FLORIDA BLVD
ALBANY LA
70711-3603
US

IV. Provider business mailing address

1812 W THOMAS ST
HAMMOND LA
70401-2945
US

V. Phone/Fax

Practice location:
  • Phone: 225-567-7772
  • Fax: 225-567-7773
Mailing address:
  • Phone: 225-567-7772
  • Fax: 225-567-7773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY.005283-IR
License Number StateLA

VIII. Authorized Official

Name: WILLIAM MCCARTHY
Title or Position: PHARMACIST IN CHARGE
Credential:
Phone: 225-567-7616