Healthcare Provider Details

I. General information

NPI: 1063808624
Provider Name (Legal Business Name): NATIONAL PHARMACY ACQUISITION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2015
Last Update Date: 04/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3202 W METAIRIE AVE S
METAIRIE LA
70001-5235
US

IV. Provider business mailing address

5344 BRITTANY DR
BATON ROUGE LA
70808-4344
US

V. Phone/Fax

Practice location:
  • Phone: 504-832-0614
  • Fax: 504-836-0056
Mailing address:
  • Phone: 225-766-7828
  • Fax: 225-612-6802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPHY.007092-IR
License Number StateLA

VIII. Authorized Official

Name: SHARON LEBOUEF
Title or Position: MANAGING MEMBER
Credential:
Phone: 225-766-7828