MEDICARE: DR. GASHEN HUMPHREY PHARMD, RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PD14199	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PD14199	OTHER	AR	ARKANSAS STATE BOARD OF PHARMACY LICENSE

General Provider Information

NPI Number	:	1043983406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GASHEN HUMPHREY PHARMD, RPH

Provider Business Mailing Address
First Line	:	1734 S 9TH ST
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71202-3526
Country	:	US
Telephone Number	:	318-387-6725
Fax Number	:

Provider Business Practice Location Address
First Line	:	1734 S 9TH ST
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71202-3526
Country	:	US
Telephone Number	:	318-387-6725
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2021
Last Update Date	:	11/21/2025

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