Healthcare Provider Details

I. General information

NPI: 1336141381
Provider Name (Legal Business Name): CRX SPECIALTY SOLUTION PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2005
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 BIENVILLE ST
NATCHITOCHES LA
71457-5702
US

IV. Provider business mailing address

407 BIENVILLE ST
NATCHITOCHES LA
71457-5702
US

V. Phone/Fax

Practice location:
  • Phone: 877-646-1716
  • Fax: 901-613-0605
Mailing address:
  • Phone: 877-646-1716
  • Fax: 901-613-0605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY.007399-IR
License Number StateLA

VIII. Authorized Official

Name: STEVEN M COBB
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 877-646-1716