Healthcare Provider Details
I. General information
NPI: 1174708127
Provider Name (Legal Business Name): BIOPLUS SPECIALTY PHARMACY LA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/08/2008
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2731 MANHATTAN BLVD STE B17
HARVEY LA
70058-6151
US
IV. Provider business mailing address
2731 MANHATTAN BLVD STE B17
HARVEY LA
70058
US
V. Phone/Fax
- Phone: 504-355-4191
- Fax: 504-355-4192
- Phone: 504-355-4191
- Fax: 504-355-4192
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336S0011X |
| Taxonomy | Specialty Pharmacy |
| License Number | PHY.006884-IR |
| License Number State | LA |
VIII. Authorized Official
Name:
ASHLEY
SHEEHAN
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 855-733-3126