Organization Active NPI

Province Pharmacy Inc

Doing business as Province Pharmacy

  • Community/Retail Pharmacy
  • Lafayette, LA
National Provider Identifier
1174008064
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PROVINCE PHARMACY INC
Doing business as
Province Pharmacy
Practice address
5000 Ambassador Caffery Pkwy Ste B
Lafayette, LA 70508-6984
Phone
(337) 534-0315
Fax
(337) 534-0616
NPI assigned
Sep 26, 2018
Last updated
Jun 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Authorized official

Name
Mona Patel, PHARMDNPI 1760852446
Title
Pharmacy Manager
Phone
(337) 534-0615

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

5000 Ambassador Caffery Pkwy Ste B
Lafayette, LA 70508-6984

Mailing address

5000 Ambassador Caffery Pkwy Ste B
Lafayette, LA 70508-6984
Phone (337) 534-0615

Other names 1

  • PROVINCE PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

5000 Ambassador Caffery Pkwy
Ste B
Lafayette, LA 70508
Phone (337) 534-0315

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748995200000",
    "number": "1174008064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 AMBASSADOR CAFFERY PKWY STE B",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086984",
            "telephone_number": "337-534-0615",
            "fax_number": "337-534-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 AMBASSADOR CAFFERY PKWY STE B",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086984",
            "telephone_number": "337-534-0315",
            "fax_number": "337-534-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVINCE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-26",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "MONA",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "337-534-0615",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROVINCE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PROVINCE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; 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.