NPIMap

Individual provider Active NPI

Connie Mabile

  • Pharmacist
  • Coushatta, LA
National Provider Identifier
1063822294
Registry record updated Apr 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15699 Issued in LA
Practice address
100 Gulf St
Coushatta, LA 71019-9014
Phone
(318) 932-5727
Fax
(318) 932-5630
NPI assigned
Apr 28, 2014
Last updated
Apr 28, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15699 LA Primary

Addresses

Primary practice location

100 Gulf St
Coushatta, LA 71019-9014

Mailing address

100 Gulf St
P.O. Box 609
Coushatta, LA 71019-9014
Phone (318) 932-5727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
15699LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mabiles Corner Pharmacy Inc Current Accepting new patients

Locations

100 Gulf St
Coushatta, LA 71019
Phone (318) 932-5727

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398643200000",
    "number": "1063822294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GULF ST",
            "address_2": "P.O. BOX 609",
            "city": "COUSHATTA",
            "state": "LA",
            "postal_code": "710199014",
            "telephone_number": "318-932-5727",
            "fax_number": "318-932-5630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GULF ST",
            "city": "COUSHATTA",
            "state": "LA",
            "postal_code": "710199014",
            "telephone_number": "318-932-5727",
            "fax_number": "318-932-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABILE",
        "first_name": "CONNIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-28",
        "last_updated": "2014-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "15699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coushatta, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; 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.