EDDIE'S PHARMACY, INC. (NPI# 1306837141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306837141 |
| Entity Type | Organization |
| Organization Name | EDDIE'S PHARMACY, INC. |
| Practice Address |
206 Choupique Ln Cottonport LA 71327-3757 |
| Practice Telephone | 3188763665 |
| Practice Fax Number | 3188763665 |
| Mailing Telephone | 3188763665 |
| Mailing Fax Number | 3188763665 |
| Enumeration Date | 2005-11-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. ROLAND EDDIE BORDELON (PRESIDENT/OWNER/CHIEF PHARMACIST) |
| Authorized Official Telephone | 3188763665 |
| Authorized Official Credential | R.PH. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | 1692-IR | LA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | DEA - US DEPT. OF JUSTICE | AE1635210 | 01 |
| LA | 1253626 | 05 | |
| LA | NABP | 1919337 | 01 |
| Street Address |
206 CHOUPIQUE LN |
| City | COTTONPORT |
| State | LA |
| Zip Code | 71327-3757 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528468808 | Kimberly Dupuy Wixson | Pharmacist | 206 Choupique Ln, Cottonport, LA 71327-3757 | 2014-08-24 |
| 1922372358 | Cottonport Corner Drug LLC | Pharmacy | 206 Choupique Ln, Cottonport, LA 71327-3757 | 2012-03-02 |
| 1295942084 | Roland Eddie Bordelon | Pharmacist | 206 Choupique Ln, Cottonport, LA 71327-3757 | 2007-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679050728 | Jamie Garrett | Nurse Practitioner | 1007 Sycamore Street, Cottonport, LA 71327 | 2018-07-22 |
| 1811403140 | Joey Lacombe | Behavioral Analyst | 1404 Highway 107, Cottonport, LA 71327 | 2017-12-22 |
| 1093933103 | Newell E. Gauthier, Jr. Md | Clinic/Center | 912 Bryan St., Cottonport, LA 71327 | 2007-04-23 |
| 1568597284 | Marlon L. Holmes | Dentist | 915 North Main St, Cottonport, LA 71327 | 2007-02-22 |
| 1932686086 | Lauren Wiley | Nurse Practitioner | 1007 Sycamore Street, Cottonport, LA 71327 | 2018-07-22 |
| 1326317090 | Marlon L Holmes, Dds A Professional Corporation | Dentist | 915 North Main St., Cottonport, LA 71327 | 2011-12-23 |
| 1316072002 | Antonina B. Holmes | Dentist | 915 North Main St., Cottonport, LA 71327-0655 | 2007-02-22 |
| 1477724995 | Louisiana Health Care Practitioners LLC | Clinic/Center | 1007 Sycamore St Ste B, Cottonport, LA 71327-3403 | 2008-03-13 |
| 1114002698 | Herndon Martin Jeansonne II | Nurse Practitioner | 1007 Sycamore St, Cottonport, LA 71327-3403 | 2006-10-25 |
| 1033735972 | Michelle Gauthier Rozas | Nurse Practitioner | 1007 Sycamore St, Cottonport, LA 71327-3403 | 2020-06-16 |
| Find all providers in zip 71327 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922372358 | Cottonport Corner Drug LLC | Pharmacy | 206 Choupique Ln, Cottonport, LA 71327-3757 | 2012-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538766563 | Bartley Enterprises | Pharmacy | 11634 Texas Hwy, Many, LA 71449 | 2020-10-02 |
| 1982218392 | Ochsner Pharmacy and Wellness LLC | Pharmacy | 2500 Belle Chasse Hwy Ste T1224, Gretna, LA 70056-7127 | 2020-09-02 |
| 1477162972 | Mercy Medical Health Center | Pharmacy | 4631 Quitman Hwy, Hodge, LA 71247 | 2020-07-30 |
| 1306470265 | Capitol City Family Health Center, Incorporated | Pharmacy | 3111 Florida Blvd Ste B, Baton Rouge, LA 70806-3774 | 2020-02-28 |
| 1215561527 | Caldwell Drug | Pharmacy | 8141 Us Hwy. 165, Columbia, LA 71418 | 2020-02-25 |
| 1962042028 | Southeast Community Health Systems Pharmacy Kentwood | Pharmacy | 734 Avenue G, Kentwood, LA 70444-2602 | 2020-01-07 |
| 1780234567 | Avita Drugs LLC | Pharmacy | 1715 Common St Ste A, Lake Charles, LA 70601-6135 | 2019-09-13 |
| 1386204659 | Highrhealth | Pharmacy | 516 N Burnside Ave, Gonzales, LA 70737-2830 | 2019-06-18 |
| 1265091474 | Medicis LLC | Pharmacy | 1727 Imperial Blvd Bldg 4, Lake Charles, LA 70605-5393 | 2019-06-11 |
| 1639642556 | Hospital Service District 1 of East Baton Rouge Parish | Pharmacy | 6300 Main St Ste 100, Zachary, LA 70791-4037 | 2019-01-03 |
| Find all providers with the same taxonomy | ||||
| City | COTTONPORT |
| Zip Code | 71327 |
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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.