NPIMap

Organization Active NPI

Abita Pharmacy Inc

  • Pharmacy
  • Abita Springs, LA
National Provider Identifier
1023199684
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
C004842-IR Issued in LA
Legal business name
ABITA PHARMACY INC
Practice address
22107 Highway 36 # B
Abita Springs, LA 70420-3949
Phone
(985) 875-9906
Fax
(985) 875-9926
NPI assigned
Oct 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael Roger ChamberlainNPI 1992800254
Title
Owner-Pic
Phone
(985) 875-9906

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X C004842-IR LA Primary

Addresses

Primary practice location

22107 Highway 36 # B
Abita Springs, LA 70420-3949

Mailing address

22107 Highway 36 Ste B
Abita Springs, LA 70420-3949
Phone (985) 875-9906

Other identifiers 1

IdentifierTypeStateIssuer
1269417MedicaidLA

National Provider Directory

National Provider Directory

Locations

22107 Highway 36
Ste B
Abita Springs, LA 70420
Phone (985) 875-9906

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023199684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22107 HIGHWAY 36 STE B",
            "city": "ABITA SPRINGS",
            "state": "LA",
            "postal_code": "704203949",
            "telephone_number": "985-875-9906",
            "fax_number": "985-875-9926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22107 HIGHWAY 36 # B",
            "city": "ABITA SPRINGS",
            "state": "LA",
            "postal_code": "704203949",
            "telephone_number": "985-875-9906",
            "fax_number": "985-875-9926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABITA PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHAMBERLAIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ROGER",
        "authorized_official_title_or_position": "OWNER-PIC",
        "authorized_official_telephone_number": "985-875-9906"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "LA",
            "license": "C004842-IR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1269417",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abita Springs, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.