MEDICARE: PILL BOX PHARMACY INCORPORATED

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	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134272644
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PILL BOX PHARMACY INCORPORATED

Provider Business Mailing Address
First Line	:	1849 LINE AVE
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71101-4611
Country	:	US
Telephone Number	:	318-865-0234
Fax Number	:	318-865-3972

Provider Business Practice Location Address
First Line	:	1849 LINE AVE
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71101-4611
Country	:	US
Telephone Number	:	318-865-0234
Fax Number	:	318-865-3972

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	JAMES DANIEL DUCK
Credential	:
Telephone Number	:	318-218-8564

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	07/10/2025

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