Healthcare Provider Details

I. General information

NPI: 1720995962
Provider Name (Legal Business Name): CALDWELL DRUG LLC LTC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8141 HIGHWAY 165
COLUMBIA LA
71418-4341
US

IV. Provider business mailing address

8141 HIGHWAY 165
COLUMBIA LA
71418-4341
US

V. Phone/Fax

Practice location:
  • Phone: 318-502-4032
  • Fax: 318-502-4033
Mailing address:
  • Phone: 318-502-4032
  • Fax: 318-502-4033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOHN TANNER MCDONALD
Title or Position: OWNER/PIC
Credential: PHARMD
Phone: 318-355-8266