Chris David Bonvillain – Pharmacist in Lafayette, LA

Key facts

NPI: 1134435720
Entity type: Individual (NPI type 1)
Primary specialty: Pharmacist 183500000X
License: 14463 (LA)
Practice address: 1850 W Pinhook Rd
Lafayette, LA 70508-3720
Phone: (337) 267-4614
NPI assigned: Aug 20, 2010
Sex: Male
Sole proprietor: No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Walgreen Co Pharmacy · Lafayette, LA · NPI 1326054826

NPD (past)
Walgreen Co Pharmacy · Longview, TX · NPI 1629956545

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
14463	LA	MD	Pharmacist

Practice roles

Organization	Specialty	Status	New patients
Walgreen Co		Past	Accepting new patients
Walgreen Co		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacist	183500000X	14463	LA	Yes

Addresses

Primary practice location

1850 W Pinhook Rd
Lafayette, LA 70508-3720

Mailing address

1850 W Pinhook Rd
Lafayette, LA 70508-3720

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 20, 2010.

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282262400000",
    "number": "1134435720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 W PINHOOK RD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 W PINHOOK RD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083720",
            "telephone_number": "337-267-4614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONVILLAIN",
        "first_name": "CHRIS",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-20",
        "last_updated": "2010-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "14463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

All providers in Lafayette, LA · Pharmacist in Louisiana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2010. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.