BRAD JOSEPH FANGUY (NPI# 1104144245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104144245 |
| Entity Type | Individual |
| Full Name | BRAD JOSEPH FANGUY |
| Credential | PHARM.D |
| Practice Address |
102 Bentwater Dr Broussard LA 70518 |
| Practice Telephone | 9858602565 |
| Mailing Telephone | 9858602565 |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2010-05-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 45092 | LA | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1899453 | 05 |
| Street Address |
102 BENTWATER DR |
| City | BROUSSARD |
| State | LA |
| Zip Code | 70518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356906911 | Allied Medicine Inc | Clinic/Center | 620 Bayou Tortue, Rd Suite 1, Broussard, LA 70518 | 2019-05-08 |
| 1578978664 | .tammy Richert | Durable Medical Equipment & Medical Supplies | 202 W Fairfield Dr, Broussard, LA 70518 | 2014-06-26 |
| 1891948642 | Dick Steven Guillory | General Practice | 805 Albertson Pkwy Ste C, Broussard, LA 70518 | 2008-10-24 |
| 1235381575 | National Seating & Mobility, Inc. | Durable Medical Equipment & Medical Supplies | 207 Roto Park Drive, Broussard, LA 70518 | 2008-10-17 |
| 1669685087 | Alison Mcclendon Charpentier | Speech-Language Pathologist | 115 Still Waters Rd., Broussard, LA 70518 | 2007-05-08 |
| 1174561526 | Inzerella Physical Therapy | Physical Therapist | 803 South Morgan Ave, Broussard, LA 70518 | 2006-06-04 |
| 1851341432 | Oceans Behavioral Hospital of Lafayette LLC | Psychiatric Hospital | 418 Albertson Parkway, Broussard, LA 70518 | 2006-05-12 |
| 1023068335 | Louisiana Guest House LLC | Skilled Nursing Facility | 418 Albertsons Parkway, Broussard, LA 70518 | 2006-05-10 |
| 1124084520 | Glenn Charles Lafleur | Family Medicine | 317 Opus One Dr, Broussard, LA 70518 | 2006-04-25 |
| 1972584746 | Lynn M. Guidry | General Practice | 109 St. Nazaire Road, Broussard, LA 70518 | 2005-11-09 |
| Find all providers in zip 70518 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962019075 | My-linh Hoang | Pharmacist | 123 Saint Nazaire Rd, Broussard, LA 70518-4202 | 2020-09-23 |
| 1750915708 | Corry Sampognaro | Pharmacist | 120 Park Center Dr, Broussard, LA 70518-3605 | 2020-02-28 |
| 1275189268 | Oy Keobupha | Pharmacist | 105 Saint Nazaire Rd, Broussard, LA 70518-4202 | 2019-08-14 |
| 1548816986 | John Steven Viguerie | Pharmacist | 103 E Main St, Broussard, LA 70518-4616 | 2019-08-12 |
| 1245885698 | Jonathan Matthew Landry | Pharmacist | 103 E Main St, Broussard, LA 70518-4616 | 2019-08-02 |
| 1710492426 | Nam Kar | Pharmacist | 105 Saint Nazaire Rd, Broussard, LA 70518-4202 | 2017-12-05 |
| 1750734976 | Dwana Sharae Day | Pharmacist | 105 Saint Nazaire Rd, Broussard, LA 70518-4202 | 2016-07-22 |
| 1114397171 | Samuel Aigbefoh | Pharmacist | 105 Saint Nazaire Rd, Broussard, LA 70518-4202 | 2015-10-03 |
| 1457760639 | Jeffrey Todd Long | Pharmacist | 123 Saint Nazaire Rd, Broussard, LA 70518-4202 | 2014-08-12 |
| 1376954750 | Ivan Landry | Pharmacist | 103 E Main St, Broussard, LA 70518-4616 | 2014-05-19 |
| Find all providers in BROUSSARD | ||||
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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.