Healthcare Provider Details

I. General information

NPI: 1598061475
Provider Name (Legal Business Name): CAUSEYS LTC PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2011
Last Update Date: 01/19/2017
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
71457-5748
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.006365-IR
License Number StateLA

VIII. Authorized Official

Name: STEVEN BOYD
Title or Position: OWNER
Credential:
Phone: 318-357-7665