Organization Active NPI

Sullivan'S Pharmacy, LTD.

  • Durable Medical Equipment & Medical Supplies
  • Zachary, LA
National Provider Identifier
1104873637
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
LA1911-IR Issued in LA
Legal business name
SULLIVAN'S PHARMACY, LTD.
Practice address
4651 Highway 19
Zachary, LA 70791-3525
Phone
(225) 654-3901
Fax
(225) 654-3685
NPI assigned
May 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Tonya Morrison, CPT
Title
Certified Pharmacy Tech/Manager
Phone
(225) 654-3901

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X LA1911-IR LA Primary
Pharmacy 333600000X LA1911-IR LA

Addresses

Primary practice location

4651 Highway 19
Zachary, LA 70791-3525

Mailing address

4651 Highway 19
Zachary, LA 70791-3525
Phone (225) 654-3901

Other identifiers 1

IdentifierTypeStateIssuer
1255572MedicaidLA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1104873637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 HIGHWAY 19",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707913525",
            "telephone_number": "225-654-3901",
            "fax_number": "225-654-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4651 HIGHWAY 19",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707913525",
            "telephone_number": "225-654-3901",
            "fax_number": "225-654-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULLIVAN'S PHARMACY, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-30",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MORRISON",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "CERTIFIED PHARMACY TECH/MANAGER",
        "authorized_official_telephone_number": "225-654-3901",
        "authorized_official_credential": "CPT"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "LA",
            "license": "LA1911-IR",
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "LA",
            "license": "LA1911-IR",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255572",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zachary, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.