Healthcare Provider Details

I. General information

NPI: 1649348889
Provider Name (Legal Business Name): OPIERX, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 03/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N CHESTNUT ST
TALLULAH LA
71282-3507
US

IV. Provider business mailing address

501 N CHESTNUT ST
TALLULAH LA
71282-3507
US

V. Phone/Fax

Practice location:
  • Phone: 318-574-6363
  • Fax: 318-574-9315
Mailing address:
  • Phone: 318-574-6363
  • Fax: 318-574-9315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY.006147-IR
License Number StateLA

VIII. Authorized Official

Name: KEVIN NUNNELEE
Title or Position: PRESIDENT
Credential:
Phone: 318-574-6363