NPIMap

Organization Active NPI

Pharmaceutical Specialties, LLC

  • Pharmacist
  • Baton Rouge, LA
National Provider Identifier
1083830517
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
3625IR Issued in LA
Legal business name
PHARMACEUTICAL SPECIALTIES, LLC
Practice address
5211 Essen LN
Suite 3
Baton Rouge, LA 70809-3564
Phone
(225) 767-1655
Fax
(225) 767-1625
NPI assigned
Apr 17, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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 Marist Bourg, PHARM.D.
Title
Co-Owner
Phone
(225) 767-1655

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 3625IR LA Primary

Addresses

Primary practice location

5211 Essen LN
Suite 3
Baton Rouge, LA 70809-3564

Mailing address

5211 Essen LN
Suite 3
Baton Rouge, LA 70809-3564
Phone (225) 767-1655

Other identifiers 1

IdentifierTypeStateIssuer
1264822MedicaidLA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083830517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5211 ESSEN LN",
            "address_2": "SUITE 3",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093564",
            "telephone_number": "225-767-1655",
            "fax_number": "225-767-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5211 ESSEN LN",
            "address_2": "SUITE 3",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093564",
            "telephone_number": "225-767-1655",
            "fax_number": "225-767-1625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACEUTICAL SPECIALTIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOURG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "MARIST",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "225-767-1655",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "3625IR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1264822",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, 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.