MEDICARE: ADVANCED PHARMACY

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	333600000X	Pharmacy	5565	LA

General Provider Information

NPI Number	:	1275532434
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED PHARMACY

Provider Business Mailing Address
First Line	:	4900 CYPRESS ST
Second Line	:	SUITE 12
City	:	WEST MONROE
State	:	LA
Zip	:	71291-7670
Country	:	US
Telephone Number	:	318-396-3575
Fax Number	:	318-397-1516

Provider Business Practice Location Address
First Line	:	4900 CYPRESS ST
Second Line	:	SUITE 12
City	:	WEST MONROE
State	:	LA
Zip	:	71291-7670
Country	:	US
Telephone Number	:	318-396-3575
Fax Number	:	318-397-1516

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. JENNY ANN NEWMAN
Credential	:
Telephone Number	:	318-396-3575

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	08/22/2020

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Directions to “ADVANCED PHARMACY ” Practice Location

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