Healthcare Provider Details

I. General information

NPI: 1508522459
Provider Name (Legal Business Name): PARKWAY PHARMACY SOUTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2021
Last Update Date: 10/18/2025
Certification Date: 10/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1666 RICHWOOD ROAD 1 STE 2
MONROE LA
71202-6892
US

IV. Provider business mailing address

1666 RICHWOOD ROAD 1 STE 2
MONROE LA
71202-6892
US

V. Phone/Fax

Practice location:
  • Phone: 318-734-0046
  • Fax: 318-734-0014
Mailing address:
  • Phone: 318-734-0046
  • Fax: 318-734-0014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LATEEF ODEYEMI
Title or Position: OWNER
Credential:
Phone: 318-243-4748