Ngoc Dang

Individual provider Active NPI Pharmacist · Broussard, LA

NPI 1154082345 · NPPES record last updated Jan 10, 2022

Key facts

NPI
1154082345
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
PST.024171 (LA)
Practice address
105 Saint Nazaire Rd
Broussard, LA 70518-4202
Phone
(337) 837-1640
NPI assigned
Jan 10, 2022
Sex
Female
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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PST.024171LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Current
since Mar 6, 2022
Accepting new patients
Walgreen Co Past
since Jan 21, 2022
Accepting new patients

Locations

105 Saint Nazaire Rd
Broussard, LA 70518
Phone (337) 837-1640

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PST.024171 LA Yes

Addresses

Primary practice location

105 Saint Nazaire Rd
Broussard, LA 70518-4202

Mailing address

3020 Mount Blanc Dr
Marrero, LA 70072-5530

Other providers in Broussard, LA

All providers in Broussard, LA · Pharmacist in Louisiana

Sources for this page

Verify at the official NPI Registry.