Brad Joseph Fanguy, PHARM.D
Individual provider Active NPI Pharmacist · Scott, LA
NPI 1104144245 · NPPES record last updated Dec 23, 2025
Key facts
- NPI
- 1104144245
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 45092 (LA)
- Practice address
- 106 Abigayle Row
Scott, LA 70583-8909 - Phone
- (337) 268-4023
- Fax
- (337) 268-4043
- NPI assigned
- May 13, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45092 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Institutional Pharmacies of Louisiana L L C | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 45092 | LA | Yes |
Addresses
Primary practice location
106 Abigayle Row
Scott, LA 70583-8909
Mailing address
106 Abigayle Row
Scott, LA 70583-8909
Phone (337) 268-4023
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1899453 | Medicaid | LA |
Other providers in Scott, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 23, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.