Healthcare Provider Details

I. General information

NPI: 1457772238
Provider Name (Legal Business Name): APOTHECARY ARTS, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2013
Last Update Date: 12/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 EXPO CIR STE 2
WEST MONROE LA
71292-9497
US

IV. Provider business mailing address

214 EXPO CIR SUITE 2
WEST MONROE LA
71292-9496
US

V. Phone/Fax

Practice location:
  • Phone: 318-509-8797
  • Fax: 318-654-7916
Mailing address:
  • Phone: 318-509-8797
  • Fax: 318-654-7916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number6798
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH WILEY
Title or Position: OWNER
Credential:
Phone: 318-396-1812