PARK PHARMACY LLC (NPI# 1619385812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619385812 |
| Entity Type | Organization |
| Organization Name | PARK PHARMACY LLC |
| Other Organization Name | PARK PHARMACY |
| Practice Address |
4811 Ambassador Caffery Pkwy Ste 101 Lafayette LA 70508-7266 |
| Practice Telephone | 3378069000 |
| Practice Fax Number | 3378069074 |
| Mailing Telephone | 3378069000 |
| Mailing Fax Number | 3378069074 |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2017-04-19 |
| Authorized Official Name | SHANE PRIMEAUX (OWNER/MANAGER) |
| Authorized Official Telephone | 3378069000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY006937IR | LA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2147229 | 01 | |
| LA | 2202910 | 05 |
| Other Name | Type Code |
|---|---|
| Park Pharmacy | Doing Business As Name - Organization |
| Street Address |
4811 AMBASSADOR CAFFERY PKWY STE 101 |
| City | LAFAYETTE |
| State | LA |
| Zip Code | 70508-7266 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868676 | Cypress Bend Oral & Maxillofacial Surgery | Dentist | 106 Rue Bastille, Lafayette, LA 70508 | 2020-07-13 |
| 1184250607 | Learning Grove Therapy LLC | Clinic/Center | 105 Anaheim Lane, Lafayette, LA 70508 | 2020-03-16 |
| 1780218727 | Jennifer Trumps | Case Manager/Care Coordinator | 200 Entergy Parkway, Lafayette, LA 70508 | 2020-02-28 |
| 1740749605 | Hunter Sy Arceneaux | Physical Therapist | 1700 Kaliste Saloom Road, Building 3, Suite 300, Lafayette, LA 70508 | 2019-03-19 |
| 1295292787 | Brad Michael Gros | Counselor | 160 South Beadle Road, Lafayette, LA 70508 | 2019-02-21 |
| 1205337581 | Alternative Perspectives, LLC | Clinic/Center | 2807 Kaliste Saloom Rd Ste B, Lafayette, LA 70508 | 2018-02-22 |
| 1124528807 | Zachariah James Hebert | Counselor | 1602 W Pinhook Rd Suite 100a, The Family Tree, Lafayette, LA 70508 | 2018-02-19 |
| 1164934477 | Ilyas Munshi, Md Apmc | Non-Pharmacy Dispensing Site | 99 W. Martial Ave, Lafayette, LA 70508 | 2017-10-26 |
| 1447761226 | Louisiana Orthopaedic Specialists, LLC | Durable Medical Equipment & Medical Supplies | 4231 Ambassador Caffery Pkwy, Suite 102, Lafayette, LA 70508 | 2017-10-19 |
| 1306365457 | Mk Dixon Counseling and Consulting | Counselor | 105 Industrial Parkway, Lafayette, LA 70508 | 2017-09-10 |
| Find all providers in zip 70508 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174008064 | Province Pharmacy Inc | Pharmacy | 5000 Ambassador Caffery Pkwy Ste B, Lafayette, LA 70508-6984 | 2018-09-26 |
| 1700385663 | Ggii Indiana, LLC | Pharmacy | 2250 Teal Rd, Lafayette, IN 47905-2218 | 2018-02-06 |
| 1962914234 | Ksc, Inc | Pharmacy | 526 Highway 52 Byp W, Lafayette, TN 37083-1614 | 2017-10-26 |
| 1447706700 | Medicine Bin Plus LLC | Pharmacy | 1105 West Willow St, Lafayette, LA 70501 | 2016-08-28 |
| 1922493337 | Neighbors Pharmacy | Pharmacy | 6770 Johnston St, Suite-a, Lafayette, LA 70503-6202 | 2015-04-02 |
| 1154663284 | Acadiana Prescription Shop South | Pharmacy | 5000 Ambassador Caffery Pkwy.,bldg 3, Suite B, Lafayette, LA 70508 | 2013-03-27 |
| 1568693505 | Falcon Pharmacy LLC | Pharmacy | 1103 Kaliste Saloom Rd Ste 103, Lafayette, LA 70508-5783 | 2009-08-06 |
| 1659437929 | Kroger Limited Partnership I | Pharmacy | 2200 Greenbush St, Lafayette, IN 47904-2342 | 2006-12-29 |
| 1285730382 | Thrifty Way Pharmacy, Northside Inc. | Pharmacy | 1419 Moss St, Lafayette, LA 70501-3654 | 2006-09-15 |
| 1881798726 | Louisiana Cvs Pharmacy, L.L.C. | Pharmacy | 3754 Moss St, Lafayette, LA 70507-5537 | 2006-09-12 |
| Find all providers in LAFAYETTE | ||||
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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.