Park Pharmacy LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

PARK PHARMACY LLC

Practice address

4811 Ambassador Caffery Pkwy Ste 101
Lafayette, LA 70508-7266

Phone

(337) 806-9000

NPI assigned

Dec 17, 2020

Last updated

May 23, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shane P PrimeauxNPI 1689923849

Title

Pharmacist in Charge

Phone

(337) 806-9000

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shane P Primeaux, RPH

  • Pharmacist
  • Lafayette, LA
  • NPI 1689923849
  NPD Authorized official

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1073109633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4811 AMBASSADOR CAFFERY PKWY STE 101",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705087266",
            "telephone_number": "337-806-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4811 AMBASSADOR CAFFERY PKWY STE 101",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705087266",
            "telephone_number": "337-806-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-17",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "PRIMEAUX",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "337-806-9000"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2202910",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juan R Paredes, MD
• Parent Partners LLC
• Ashley Romero Parich, PA-C
• Parish Anesthesia Endoscopy of Lafayette, LLC
• Park Pediatric Dentistry, LLC
• Park Pharmacy LLC (Park Pharmacy)
• Park Place Surgery Center, LLC
• Angel Nicole Parker, LPN
• Devin Dorian Parker
• Janet Parker, P.T.

• Long Term Care Pharmacy in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Long Term Care Pharmacy in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.