Healthcare Provider Details

I. General information

NPI: 1891888236
Provider Name (Legal Business Name): KAR PHARMACY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2006
Last Update Date: 10/29/2020
Certification Date: 10/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

484 LOUISIANA AVE
PORT ALLEN LA
70767-2141
US

IV. Provider business mailing address

PO BOX 116
MARINGOUIN LA
70757-0116
US

V. Phone/Fax

Practice location:
  • Phone: 225-344-1077
  • Fax: 225-344-4408
Mailing address:
  • Phone: 225-625-2353
  • Fax: 225-625-3144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number006877-IR
License Number StateLA

VIII. Authorized Official

Name: JUSTIN SOULIER
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 225-485-1049