Rosepine Family Pharmacy Inc

Organization Active NPI Community/Retail Pharmacy · Rosepine, LA

NPI 1114031192 · NPPES record last updated Jul 11, 2016

Key facts

NPI
1114031192
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
PHY.002000-IR (LA)
Legal business name
ROSEPINE FAMILY PHARMACY INC
Practice address
18507 Central Ave
Rosepine, LA 70659
Phone
(337) 462-0177
Fax
(337) 462-0078
NPI assigned
Aug 18, 2006
Organization subpart
No

Authorized official

Name
Matthew Peterson
Title
Owner
Phone
(337) 462-0177

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY.002000-IR LA Yes
Compounding Pharmacy 3336C0004X
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

18507 Central Ave
Rosepine, LA 70659

Mailing address

PO Box 408
Rosepine, LA 70659-0408
Phone (337) 462-0177

Other identifiers

IdentifierTypeStateIssuer
2032133OtherPK
1256340MedicaidLA

Other names

  • ROSEPINE FAMILY PHARMACY Doing business as

Other providers in Rosepine, LA

All providers in Rosepine, LA · Community/Retail Pharmacy in Louisiana

Sources for this page

Verify at the official NPI Registry.