JEWELLA AVENUE PHARMACY (NPI# 1982962890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982962890 |
| Entity Type | Organization |
| Organization Name | JEWELLA AVENUE PHARMACY |
| Practice Address |
3610 Jewella Ave Suite B Shreveport LA 71109-4700 |
| Mailing Address |
1408 Cross Lake Cir Shreveport LA 71109-1935 |
| Practice Telephone | 3182883432 |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2012-04-27 |
| Authorized Official Name | KAWANDA WILLIAMS (OWNER) |
| Authorized Official Telephone | 3182883432 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | Suppliers |
| Street Address |
3610 JEWELLA AVE SUITE B |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71109-4700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548784416 | Barbara Smith | Counselor | 4019 Greenwood Road, Shreveport, LA 71109 | 2017-08-01 |
| 1508306135 | Cherise Sims | Case Manager/Care Coordinator | 3512 Greenbriar Dr, Shreveport, LA 71109 | 2017-03-01 |
| 1174063093 | Nitika Pinesett | Case Manager/Care Coordinator | 3011 Independence Ave, Shreveport, LA 71109 | 2017-02-24 |
| 1831640986 | Aleric Hamilton | Counselor | 2605 Leaf Ln, Shreveport, LA 71109 | 2016-10-24 |
| 1144673963 | Lakeishia Johnson | Technician | 5342 Broadway Ave, Shreveport, LA 71109 | 2016-07-16 |
| 1083074223 | Patricia Pouncy | Counselor | 4019 Greenwood Rd, Shreveport, LA 71109 | 2016-03-01 |
| 1326418518 | Deepasulochana Sivasankaraganesan | Dentist | 3719 Jewella Ave, Shreveport, LA 71109 | 2015-09-30 |
| 1063611838 | Della Edwards Wills | Social Worker | 4615 Monkhouse Drive, Ste A-2-b, Shreveport, LA 71109 | 2007-07-12 |
| 1083743041 | An Endless Love Home Care, LLC | Point of Service | 6259 Tinker Street, Shreveport, LA 71109 | 2007-03-05 |
| 1316009624 | Djenane Rousseau | Pharmacist | 4140 Hollywood, Shreveport, LA 71109 | 2006-12-14 |
| Find all providers in zip 71109 | ||||
| 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 |
|---|---|---|---|---|
| 1588036552 | Brfhh Shreveport LLC | Pharmacy | 1541 Kings Hwy Rm Eg-10, Shreveport, LA 71103-4228 | 2015-10-29 |
| 1265675029 | Martin Luther King Health Center | Pharmacy | 1233 Sprague St., Shreveport, LA 71101 | 2009-04-09 |
| 1134272644 | Pill Box Pharmacy Incorporated | Pharmacy | 1849 Line Ave, Shreveport, LA 71101-4611 | 2007-01-19 |
| 1114090446 | Brookshire Grocery Company | Pharmacy | 388 Bert Kouns Loop, Attention Pharmacy Dept, Shreveport, LA 71106-8123 | 2006-11-16 |
| 1952474421 | Brookshire Grocery Company | Pharmacy | 3620 Pines Rd, Attention Pharmacy Dept, Shreveport, LA 71119-5206 | 2006-11-15 |
| 1861565335 | Brookshire Grocery Company | Pharmacy | 510 Kings Hwy, Attention Pharmacy Dept, Shreveport, LA 71104-4444 | 2006-11-15 |
| 1316010887 | Brookshire Grocery Company | Pharmacy | 5828 Line Ave, Attention Pharmacy Dept, Shreveport, LA 71106-1532 | 2006-11-15 |
| 1225101793 | Brookshire Grocery Company | Pharmacy | 3000 N Market St, Attention Pharmacy Dept, Shreveport, LA 71107-4062 | 2006-11-15 |
| 1780757252 | Brookshire Grocery Company | Pharmacy | 2640 Waggoner Ave, Attention Pharmacy Dept, Shreveport, LA 71108-3859 | 2006-11-15 |
| 1134292600 | Brookshire Grocery Company | Pharmacy | 9250 Mansfield Rd, Attention Pharmacy Dept, Shreveport, LA 71118-3125 | 2006-11-15 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71109 |
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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.