IDEAL HEALTH MART PHARMACY INC (NPI# 1568510030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568510030 |
| Entity Type | Organization |
| Organization Name | IDEAL HEALTH MART PHARMACY INC |
| Other Organization Name | IDEAL HEALTH MART |
| Practice Address |
610 N Pine St Deridder LA 70634-3546 |
| Practice Telephone | 3374637210 |
| Practice Fax Number | 3374620930 |
| Mailing Telephone | 3374637210 |
| Mailing Fax Number | 3374620930 |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2014-05-16 |
| Authorized Official Name | KESA LANE (RPH/OWNER) |
| Authorized Official Telephone | 3374637210 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | 006477 | LA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2201344 | 05 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 1902801 | 01 |
| Other Name | Type Code |
|---|---|
| ideal health mart | Doing Business As Name - Organization |
| Street Address |
610 N PINE ST |
| City | DERIDDER |
| State | LA |
| Zip Code | 70634-3546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538475991 | Kesa Lane | Pharmacist | 610 N Pine St, Deridder, LA 70634-3546 | 2010-08-24 |
| 1639171325 | George Edward Leray | Pharmacist | 610 N Pine St, Deridder, LA 70634-3546 | 2005-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861016164 | Just Health | Clinic/Center | 411 Bolivar Bishop Dr, Deridder, LA 70634 | 2020-06-02 |
| 1477193183 | Stacey Marie Legros | Occupational Therapy Assistant | 19503 Highway 171, Deridder, LA 70634 | 2020-01-10 |
| 1487296588 | Imperial Health LLP | Internal Medicine | 200 W 5th Street, Deridder, LA 70634 | 2019-10-10 |
| 1902367568 | Residential Therapy Solutions, LLC | Physical Therapist | 19503 Hwy 171, Deridder, LA 70634 | 2019-03-27 |
| 1023583044 | Calcasieu Urgent Care LLC | Clinic/Center | 1017 N Pine Street, Deridder, LA 70634 | 2018-10-05 |
| 1235638222 | Melanie Welch, Fnp, LLC | Nurse Practitioner | 1420 Blankenship Dr., Deridder, LA 70634 | 2018-02-06 |
| 1265976617 | Jennifer Dianne Midgett | Nurse Practitioner | 2581 Highway 190 W, Deridder, LA 70634 | 2016-12-05 |
| 1821419334 | Beauregard Hematolog & Oncology | Internal Medicine | 301 S. Washington St., Ste B, Deridder, LA 70634 | 2013-12-31 |
| 1982835013 | Kathern Sue Hollifield | Physical Therapist | 309 S. Washington St., Beauregard Physical Therapy Clinic Inc, Deridder, LA 70634 | 2009-08-06 |
| 1750541777 | Tracy Winkley | Physical Therapist | 1744 Ball Rd, Deridder, LA 70634 | 2008-06-12 |
| Find all providers in zip 70634 | ||||
| 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 |
|---|---|---|---|---|
| 1689773905 | Brookshire Brothers Inc | Pharmacy | 1103 W 1st St, Deridder, LA 70634-3705 | 2006-09-22 |
| 1003827510 | Thrifty Way Pharmacy of Deridder Inc No 2 | Pharmacy | 601 S Pine St, Deridder, LA 70634-4941 | 2006-08-10 |
| 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 | ||||
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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.