Healthcare Provider Details

I. General information

NPI: 1730323627
Provider Name (Legal Business Name): CARMICHAEL'S LTC OF CROWLEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2009
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 N PARKERSON AVE
CROWLEY LA
70526-3613
US

IV. Provider business mailing address

1004 N PARKERSON AVE
CROWLEY LA
70526-3613
US

V. Phone/Fax

Practice location:
  • Phone: 337-785-3102
  • Fax: 337-785-3109
Mailing address:
  • Phone: 337-785-3102
  • Fax: 337-785-3109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number6015 IR
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number6015 IR
License Number StateLA

VIII. Authorized Official

Name: MRS. ANGEL BARRON
Title or Position: CFO
Credential: CPA, CGMA
Phone: 337-785-3182