MEDICARE: HOTBAR LLC

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
2	3336C0003X	Community/Retail Pharmacy	6121	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2035354	OTHER		PK

General Provider Information

NPI Number	:	1447265061
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOTBAR LLC

Provider Business Mailing Address
First Line	:	10374 HIGHWAY 165 N
Second Line	:	STE C
City	:	STERLINGTON
State	:	LA
Zip	:	71280-3320
Country	:	US
Telephone Number	:	318-330-9393
Fax Number	:	318-324-8610

Provider Business Practice Location Address
First Line	:	1470 GARRETT RD STE A
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71202-3938
Country	:	US
Telephone Number	:	318-330-9393
Fax Number	:	318-324-8610

Authorized Official
Title or Position	:	PHARMACIST
Name	:	A NICOLE HOTARD
Credential	:
Telephone Number	:	318-330-6363

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	02/08/2016

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Directions to “HOTBAR LLC ” Practice Location

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