Healthcare Provider Details

I. General information

NPI: 1336909431
Provider Name (Legal Business Name): AIRLINE DRUG LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2024
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10465 NORRIS FERRY RD STE B
SHREVEPORT LA
71106
US

IV. Provider business mailing address

406 N ARKANSAS ST
SPRINGHILL LA
71075-2602
US

V. Phone/Fax

Practice location:
  • Phone: 318-693-1220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JAMES DANIEL DUCK
Title or Position: MANAGER
Credential:
Phone: 318-539-3199