Healthcare Provider Details

I. General information

NPI: 1447265061
Provider Name (Legal Business Name): HOTBAR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 02/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1470 GARRETT RD STE A
MONROE LA
71202-3938
US

IV. Provider business mailing address

10374 HIGHWAY 165 N STE C
STERLINGTON LA
71280-3320
US

V. Phone/Fax

Practice location:
  • Phone: 318-330-9393
  • Fax: 318-324-8610
Mailing address:
  • Phone: 318-330-9393
  • Fax: 318-324-8610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number6121
License Number StateLA

VIII. Authorized Official

Name: A NICOLE HOTARD
Title or Position: PHARMACIST
Credential:
Phone: 318-330-6363