Healthcare Provider Details

I. General information

NPI: 1922355528
Provider Name (Legal Business Name): BARTLEY ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2012
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3199 HWY 71
CAMPTI LA
71411
US

IV. Provider business mailing address

3199 HIGHWAY 71
CAMPTI LA
71411-4061
US

V. Phone/Fax

Practice location:
  • Phone: 318-476-4877
  • Fax: 318-476-4800
Mailing address:
  • Phone: 318-476-4877
  • Fax: 318-476-4800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. VINCE L BARTLEY
Title or Position: OWNER
Credential: R.PH
Phone: 318-646-6877