Southland Drugs No 2 Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY.001493-IR Issued in LA

Legal business name

SOUTHLAND DRUGS NO 2 INC

Practice address

1117 Audubon Ave
Thibodaux, LA 70301-4940

Phone

(985) 447-5852

Fax

(985) 447-4484

NPI assigned

Jan 11, 2007

Organization subpart

No

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

Authorized official

Name

Jenny Guillot, RPH

Title

President

Phone

(985) 447-5852

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• SOUTHLAND DRUGS #2 Doing business as

Locations

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1033269352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 AUDUBON AVE",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014940",
            "telephone_number": "985-447-5852",
            "fax_number": "985-447-4484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 AUDUBON AVE",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014940",
            "telephone_number": "985-447-5852",
            "fax_number": "985-447-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAND DRUGS NO 2 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A",
        "authorized_official_last_name": "GUILLOT",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "985-447-5852",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "PHY.001493-IR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1251542",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1902231",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHLAND DRUGS #2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Thibodaux, LA
• Providers in Thibodaux, LA by specialty
• Community/Retail Pharmacy in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.