Healthcare Provider Details

I. General information

NPI: 1861775009
Provider Name (Legal Business Name): GPS ACUTE CARE PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2011
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1039 E HIGHWAY 30 SUITE B
GONZALES LA
70737-4757
US

IV. Provider business mailing address

1039 E HIGHWAY 30 SUITE B
GONZALES LA
70737-4757
US

V. Phone/Fax

Practice location:
  • Phone: 225-644-4853
  • Fax:
Mailing address:
  • Phone: 225-644-4853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number6077
License Number StateLA

VIII. Authorized Official

Name: JOSEPH SCOTT BLACK
Title or Position: DIRECTOR OF PHARMACY
Credential: PHARMACIST
Phone: 225-644-4853