VIDRINE PHARMACEUTICAL GROUP, LLC (NPI# 1043838469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043838469 |
| Entity Type | Organization |
| Organization Name | VIDRINE PHARMACEUTICAL GROUP, LLC |
| Practice Address |
404 E Prien Lake Rd Lake Charles LA 70601-8507 |
| Practice Telephone | 3374367216 |
| Mailing Telephone | 3374367216 |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2020-07-17 |
| Authorized Official Name | MR. JESSE VIDRINE (OWNER) |
| Authorized Official Telephone | 3374367216 |
| Is Organization Subpart | Y |
| Parent Organization Name | VIDRINE PHARMACEUTICAL GROUP, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Boudreaux's New Drug Store | Doing Business As Name - Organization |
| Street Address |
404 E PRIEN LAKE RD |
| City | LAKE CHARLES |
| State | LA |
| Zip Code | 70601-8507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386245793 | Stacy Lee Teer | Pharmacist | 404 E Prien Lake Rd, Lake Charles, LA 70601-8507 | 2020-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144833872 | Fresenius Medical Care Sulphur, LLC | Clinic/Center | 330 Chavanne Street, Lake Charles, LA 70601 | 2020-08-24 |
| 1174158844 | Andrea Cormier | Peer Specialist | 751 E Bayou Pines Drive, Suite C, Lake Charles, LA 70601 | 2020-03-03 |
| 1588297303 | Vivian Claire Miller Monceaux | Chiropractor | 780 Bayou Pines East Drive, Lake Charles, LA 70601 | 2020-02-20 |
| 1568001014 | Swla Center for Health Services | Clinic/Center | 3820 Senator J. Bennett Johnston Ave, Charleston Bldg 8, Lake Charles, LA 70601 | 2020-01-02 |
| 1417512070 | Ryan Nathaniel Vaisler | Student in an Organized Health Care Education/Training Program | 1525 Oak Park Blvd., Lake Charles, LA 70601 | 2019-05-08 |
| 1336600675 | Hoh Palliative Care, LLC | Family Medicine | 750 East Bayou Pines, Suite A, Lake Charles, LA 70601 | 2019-03-28 |
| 1073079026 | Alawrass LLC | Pharmacy | 803 E Prien Lake Rd, Lake Charles, LA 70601 | 2019-02-14 |
| 1861962722 | Ellaweena Woods | Counselor | 1409 Kirkman St., Lake Charles, LA 70601 | 2018-12-04 |
| 1770051963 | Hanna Marie Rodriguez | Counselor | 751 Bayou Pines Drive, Suite C, Lake Charles, LA 70601 | 2018-11-06 |
| 1023585213 | Shandora Druilhet | Case Manager/Care Coordinator | 751 E Bayou Pines, Lake Charles, LA 70601 | 2018-10-26 |
| Find all providers in zip 70601 | ||||
| Taxonomy Code | 3336C0004X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Compounding Pharmacy |
| A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner’s Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. |
| Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093959983 | Carmichael's Pharmacy Ihp | Pharmacy | 1725 W Sale Rd, Lake Charles, LA 70605-2521 | 2009-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124667027 | Jc Pharmacy, LLC | Pharmacy | 3329 Hwy 371, Ringgold, LA 71068 | 2019-12-26 |
| 1831750470 | Lapharmacy LLC | Pharmacy | 839 S Clearview Pkwy, Jefferson, LA 70121-3119 | 2019-06-25 |
| 1811387673 | Healthscripts of America - Southeast Louisiana, LLC. | Pharmacy | 2395 Gause Blvd E, Suite 11, Slidell, LA 70461-6010 | 2015-02-02 |
| 1801209051 | Gulf States Health Partners LLC | Pharmacy | 7855 Howell Blvd Ste 160, Baton Rouge, LA 70807-5257 | 2014-06-05 |
| 1457772238 | Apothecary Arts, L.L.C. | Pharmacy | 214 Expo Cir Ste 2, West Monroe, LA 71292-9497 | 2013-12-23 |
| 1295166254 | Ruston Wellness & Compounding Pharmacy | Pharmacy | 109 N Trenton St # 2, Ruston, LA 71270-4321 | 2013-12-02 |
| 1497190227 | Medical Pharmacy Inc. | Pharmacy | 4965 W. Park Drive, Zachary, LA 70791 | 2013-05-07 |
| 1487990818 | Icare Phamacy LLC | Pharmacy | 2807 Kaliste Saloom Rd, Lafayette, LA 70508-7141 | 2012-12-12 |
| 1164759759 | M&m Pharmacy LLC | Pharmacy | 311 Dixie Plz, Natchitoches, LA 71457-5880 | 2009-11-03 |
| 1588896245 | Northlake Pharmacy Inc | Pharmacy | 7047 Highway 190 East Service Rd, East Service Road, Covington, LA 70433-4955 | 2009-08-13 |
| Find all providers with the same taxonomy | ||||
| City | LAKE CHARLES |
| Zip Code | 70601 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.