Organization Active NPI

Gray Pharm Incorporated

  • Community/Retail Pharmacy
  • Monroe, LA
National Provider Identifier
1114413705
Registry record updated Jul 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY.007717-IR Issued in LA
Legal business name
GRAY PHARM INCORPORATED
Doing business as
The Pharmacy Shoppe
Practice address
1510 S 2ND St
Monroe, LA 71202-2742
Phone
(318) 323-2883
Fax
(318) 323-2883
NPI assigned
Jul 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2018

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

Authorized official

Name
Bartholemew Hardwell
Title
Pharmacist
Phone
(318) 323-2883

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY.007717-IR LA Primary

Addresses

Primary practice location

1510 S 2ND St
Monroe, LA 71202-2742

Mailing address

1510 S 2ND St
Monroe, LA 71202-2742
Phone (318) 323-2883

Other names 1

  • The Pharmacy Shoppe Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530835200000",
    "number": "1114413705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 S 2ND ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712022742",
            "telephone_number": "318-323-2883",
            "fax_number": "318-323-2883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 S 2ND ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712022742",
            "telephone_number": "318-323-2883",
            "fax_number": "318-323-2883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAY PHARM INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-06",
        "last_updated": "2018-07-06",
        "status": "A",
        "authorized_official_last_name": "HARDWELL",
        "authorized_official_first_name": "BARTHOLEMEW",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "318-323-2883"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "PHY.007717-IR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Pharmacy Shoppe",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Pharmacy Shoppe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2018; 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.