Healthcare Provider Details

I. General information

NPI: 1821393653
Provider Name (Legal Business Name): CMAP EXPRESS PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2011
Last Update Date: 01/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 JOHNSTON ST SUITE B
ALEXANDRIA LA
71301-7638
US

IV. Provider business mailing address

929 JOHNSTON ST SUITE B
ALEXANDRIA LA
71301-7638
US

V. Phone/Fax

Practice location:
  • Phone: 318-484-2773
  • Fax: 318-484-2775
Mailing address:
  • Phone: 318-484-2773
  • Fax: 318-484-2775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number5667-CH
License Number StateLA

VIII. Authorized Official

Name: MR. KEVIN PAUL BROWN
Title or Position: PHARMACIST-IN-CHARGE
Credential: PHARM D
Phone: 318-484-2773