Healthcare Provider Details

I. General information

NPI: 1497059661
Provider Name (Legal Business Name): SBS HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2011
Last Update Date: 01/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21385 MARION LN SUITE B
MANDEVILLE LA
70471-8714
US

IV. Provider business mailing address

21385 MARION LN SUITE B
MANDEVILLE LA
70471-8714
US

V. Phone/Fax

Practice location:
  • Phone: 985-327-0100
  • Fax: 985-327-0105
Mailing address:
  • Phone: 985-327-0100
  • Fax: 985-327-0105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LOUIS SUMMERSGILL
Title or Position: OWNER
Credential:
Phone: 985-327-0100