Healthcare Provider Details

I. General information

NPI: 1710281134
Provider Name (Legal Business Name): LOUISIANA INSTITUTIONAL PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2010
Last Update Date: 04/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7515 CAMERON ST
DUSON LA
70529-3312
US

IV. Provider business mailing address

522 W. PINHOOK
LAFAYETTE LA
70503
US

V. Phone/Fax

Practice location:
  • Phone: 337-873-7575
  • Fax: 337-265-2446
Mailing address:
  • Phone: 337-265-2445
  • Fax: 337-265-2446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License NumberPHY.006334-IR
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPHY006334-IR
License Number StateLA

VIII. Authorized Official

Name: MRS. SHELLEY G. MILLER
Title or Position: PHARMACIST IN CHARGE
Credential: RPH
Phone: 337-265-2445