NPIMap

Organization Active NPI

Northside Family Pharmacy

  • Pharmacist
  • Denham Springs, LA
National Provider Identifier
1104913342
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
11338 Issued in LA
Legal business name
NORTHSIDE FAMILY PHARMACY
Practice address
850 Cockerham Rd
Denham Springs, LA 70726-2645
Phone
(225) 664-9520
Fax
(225) 664-5769
NPI assigned
Oct 9, 2006
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
Mr. Gary Scott Maples
Title
President
Phone
(225) 664-9520

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 11338 LA Primary

Addresses

Primary practice location

850 Cockerham Rd
Denham Springs, LA 70726-2645

Mailing address

850 Cockerham Rd
Denham Springs, LA 70726-2645
Phone (225) 664-9520

Other identifiers 1

IdentifierTypeStateIssuer
1264130MedicaidLA

National Provider Directory

National Provider Directory

Locations

850 Cockerham Rd
Denham Springs, LA 70726
Phone (225) 664-9520

NPI Registry JSON

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104913342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 COCKERHAM RD",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707262645",
            "telephone_number": "225-664-9520",
            "fax_number": "225-664-5769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 COCKERHAM RD",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707262645",
            "telephone_number": "225-664-9520",
            "fax_number": "225-664-5769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE FAMILY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAPLES",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "225-664-9520",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "11338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1264130",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denham Springs, 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.