Healthcare Provider Details

I. General information

NPI: 1124667027
Provider Name (Legal Business Name): RINGGOLD PHARMACY & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2019
Last Update Date: 10/20/2022
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2431 MILITARY RD
RINGGOLD LA
71068-2597
US

IV. Provider business mailing address

PO BOX 729
BENTON LA
71006-0729
US

V. Phone/Fax

Practice location:
  • Phone: 318-894-0278
  • Fax: 318-894-0283
Mailing address:
  • Phone: 318-525-8165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOHN BANNISTER
Title or Position: MANAGER
Credential:
Phone: 318-927-3523