Healthcare Provider Details

I. General information

NPI: 1811387673
Provider Name (Legal Business Name): HEALTHSCRIPTS OF AMERICA - SOUTHEAST LOUISIANA, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2015
Last Update Date: 02/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2395 GAUSE BLVD E SUITE 11
SLIDELL LA
70461-6010
US

IV. Provider business mailing address

6565 WEST LOOP S SUITE 110
BELLAIRE TX
77401-3500
US

V. Phone/Fax

Practice location:
  • Phone: 832-770-8194
  • Fax: 832-770-8196
Mailing address:
  • Phone: 832-770-8194
  • Fax: 832-770-8196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY.007064-IR
License Number StateLA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: PAUL HENRIKSEN
Title or Position: CEO
Credential:
Phone: 832-770-8194