Healthcare Provider Details

I. General information

NPI: 1124567516
Provider Name (Legal Business Name): NORTH LOUISIANA INSTITUTIONAL PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2017
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 BIENVILLE ST STE B
NATCHITOCHES LA
71457-5746
US

IV. Provider business mailing address

405 BIENVILLE ST STE B
NATCHITOCHES LA
71457-5746
US

V. Phone/Fax

Practice location:
  • Phone: 318-357-7665
  • Fax: 318-352-1881
Mailing address:
  • Phone: 318-357-7665
  • Fax: 318-352-1881

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.007475-IR
License Number StateLA

VIII. Authorized Official

Name: NICOLE HOWARD
Title or Position: COO
Credential:
Phone: 318-445-6470