SOUTHEAST COMMUNITY HEALTH SYSTEMS PHARMACY KENTWOOD (NPI# 1962042028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962042028 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST COMMUNITY HEALTH SYSTEMS PHARMACY KENTWOOD |
| Practice Address |
734 Avenue G Kentwood LA 70444-2602 |
| Mailing Address |
Po Box 770 Zachary LA 70791-0770 |
| Practice Telephone | 2253062100 |
| Practice Fax Number | 9852296828 |
| Mailing Telephone | 2253062000 |
| Mailing Fax Number | 2256581282 |
| Enumeration Date | 2020-01-07 |
| Last Update Date | 2020-01-07 |
| Authorized Official Name | DR. ALECIA CYPRIAN (CEO) |
| Authorized Official Telephone | 2253062000 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHEAST COMMUNITY HEALTH SYSTEMS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | Suppliers |
| Street Address |
734 AVENUE G |
| City | KENTWOOD |
| State | LA |
| Zip Code | 70444-2602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437703733 | Bridge Builders Consultants, LLC | In Home Supportive Care | Bridge Builders Consultants, LLC, 505 Avenue F, Ste A, Kentwood, LA 70444 | 2019-07-25 |
| 1336577576 | Penny Scardulla | Pharmacist | 717 Ave. G, Kentwood, LA 70444 | 2013-10-25 |
| 1891034716 | Freds Stores of Tennessee Inc | Pharmacy | 734 Avenue G # 38, Kentwood, LA 70444 | 2013-02-13 |
| 1407177348 | Bryan D. Tate Jr. | Nurse Practitioner | 919 Avenue G, Kentwood, LA 70444 | 2010-06-15 |
| 1174737720 | Harmony Center, Inc. | Intermediate Care Facility, Mental Illness | 1551 Cb Temple Sr. Road, Kentwood, LA 70444 | 2007-05-10 |
| 1780050294 | Kentwood Family Clinic LLC | Nurse Practitioner | 919 Avenue G, Kentwood, LA 70444 | 2015-08-19 |
| 1467670349 | Daryl Marshall Westmoreland Sr. | Dentist | 68144 Highway 51, 68144 Highway 51, Kentwood, LA 70444-0432 | 2007-04-23 |
| 1962989053 | Lets Keep It Moving Transportation | Non-emergency Medical Transport (VAN) | 412 7th St, Kentwood, LA 70444-2308 | 2018-07-23 |
| 1174009351 | Tamika Dickerson | Driver | 412 7th St, Kentwood, LA 70444-2308 | 2018-07-11 |
| 1013468909 | Southeast Community Health Systems | Clinic/Center | 603 9th St, Kentwood, LA 70444-2317 | 2016-10-17 |
| Find all providers in zip 70444 | ||||
| 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 |
|---|---|---|---|---|
| 1538405774 | Ltc Pharmacy, LLC | Pharmacy | 4477 E Paris Ave Se, Kentwood, MI 49512-5312 | 2012-12-17 |
| 1720185390 | United Pharmaceutical Services Inc. | Pharmacy | 4443 Breton Rd Se Ste A, Kentwood, MI 49508-8424 | 2006-09-17 |
| 1184660573 | Brown Morris Pharmacy Inc | Pharmacy | 717 Avenue G, Kentwood, LA 70444-2601 | 2006-06-22 |
| 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 |
| 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 |
| 1104397900 | Gretna Xpress Pharmacy LLC | Pharmacy | 1620 Belle Chasse Hwy Ste A, Terrytown, LA 70056-7057 | 2018-12-06 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SOUTHEAST COMMUNITY HEALTH SYSTEMS PHARMACY KENTWOOD.
| 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.