=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598845448
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MEDICINE CHEST PHARMACY INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/16/2006
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 409 E LINCOLN RD
-----------------------------------------------------
City | VILLE PLATTE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70586-3431
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-363-8065
-----------------------------------------------------
Fax | 337-363-0832
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 409 E LINCOLN RD
-----------------------------------------------------
City | VILLE PLATTE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70586-3431
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-363-8065
-----------------------------------------------------
Fax | 337-363-0832
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PRESIDENT/CHIEF PHARMACIST
-----------------------------------------------------
Name | JAMES GARY SOILEAU
-----------------------------------------------------
Credential | P.D.
-----------------------------------------------------
Telephone | 337-363-8065
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 2031-IR
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0004X
-----------------------------------------------------
Taxonomy Name | Compounding Pharmacy
-----------------------------------------------------
License Number | 2031-IR
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------