Active NPI
Quintin Good
- Pharmacist
- Ruston, LA
National Provider Identifier
1104581974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PST.024013
- Practice address
- 108 W California Ave
Ruston, LA 71270-5014 - Phone
- (318) 255-1811
- NPI assigned
- Nov 5, 2021
- Last updated
- Nov 5, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PST.024013 | LA | Primary |
Addresses
Primary practice location
108 W California Ave
Ruston, LA 71270-5014
Mailing address
1402 Saint John Ave
Ruston, LA 71270-5244
Phone (225) 933-0666
Other practice location 1
1401 N Trenton St
Ruston, LA 71270-2325
Phone (318) 254-8731
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
| License | State | Type | Specialty |
|---|---|---|---|
| PST.024013 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
108 W California Ave
Ruston, LA 71270
Phone (318) 255-1811
Organizations & group practices 3
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": "1636070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636070400000",
"number": "1104581974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1402 SAINT JOHN AVE",
"city": "RUSTON",
"state": "LA",
"postal_code": "712705244",
"telephone_number": "225-933-0666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 W CALIFORNIA AVE",
"city": "RUSTON",
"state": "LA",
"postal_code": "712705014",
"telephone_number": "318-255-1811"
}
],
"practiceLocations": [
{
"address_1": "1401 N Trenton St",
"address_purpose": "LOCATION",
"city": "Ruston",
"state": "LA",
"postal_code": "712702325",
"country_code": "US",
"telephone_number": "318-254-8731",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOOD",
"first_name": "QUINTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-05",
"last_updated": "2021-11-05",
"certification_date": "2021-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "PST.024013",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ruston, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.