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General NPI Number Information
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NPI Number | 1770543464
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Entity Type | Organization
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Legal Business Name | WEST CARROLL MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 03/25/2006
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Last Update Date | 12/12/2023
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Provider Practice Location Address
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Address Line | 706 ROSS ST
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City | OAK GROVE
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State | LA
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Zip | 71263-9798
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Country | US
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Telephone | 318-428-6155
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Fax | 318-428-6172
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Provider Business Mailing Address
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Address Line | 706 ROSS ST
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City | OAK GROVE
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State | LA
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Zip | 71263-9798
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Country | US
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Telephone | 318-428-6155
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Fax | 318-428-6172
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Authorized Official
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Title or Position | AUTH REP PHARM DIRECTOR
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Name | KELLI SCIARA
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Credential | RPH
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Telephone | 318-428-6252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5244-IR
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License Number State | LA
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