Bryan W Prince, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PST.019271 Issued in LA

Practice address

9983 Bluebonnet Blvd
Baton Rouge, LA 70810-6458

Phone

(225) 769-4208

NPI assigned

Oct 25, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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
  • Baton Rouge, LA
  • NPI 1417963919
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287964800000",
    "number": "1164722179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 GLENMORE AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708065217",
            "telephone_number": "901-355-6914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9983 BLUEBONNET BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708106458",
            "telephone_number": "225-769-4208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "BRYAN",
        "middle_name": "W",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-25",
        "last_updated": "2010-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "PST.019271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOUISIANA BOARD OF PHARMACY",
            "identifier": "MA001133",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOUISIANA BOARD OF PHARMACY",
            "identifier": "PST091271",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WALGREENS",
            "identifier": "1079256",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prime Route Transportation LLC
• Lauren Primeaux
• Primitive Care Services
• Christina Elizabeth Primo, AU.D.
• Alise Maria Prince
• Caulin W Prince
• Monique Annette Prince
• Stacy Renee Prine
• Jeremy Priola
• Sydney Priola, DPT

• Pharmacist in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Pharmacist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; 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.