Greensburg Family Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY.006667-IR Issued in LA

Legal business name

GREENSBURG FAMILY PHARMACY LLC

Practice address

6166 Hwy 10
Greensburg, LA 70441

Phone

(225) 222-4279

Fax

(225) 222-4043

NPI assigned

Feb 25, 2013

Organization subpart

No

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

Authorized official

Name

Michael Tinnerello

Title

Manager/Owner

Phone

(985) 320-5175

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Greensburg Family Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Greensburg Family Pharmacy

  • Community/Retail Pharmacy
  • Greensburg, LA
  • NPI 1063114890

  O20181127000085

  Same enrollment

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly Phillips Lambert, RPH

  • Pharmacist
  • Greensburg, LA
  • NPI 1639411333
  NPD
• Rachel Lynn Fedele Spitale

  • Pharmacist
  • Greensburg, LA
  • NPI 1346886967
  NPD (past)

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

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595376000000",
    "number": "1174863344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 W THOMAS ST",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704012945",
            "telephone_number": "985-345-4767",
            "fax_number": "985-345-4768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6166 HWY 10",
            "city": "GREENSBURG",
            "state": "LA",
            "postal_code": "70441",
            "telephone_number": "225-222-4279",
            "fax_number": "225-222-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENSBURG FAMILY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-25",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A",
        "authorized_official_last_name": "TINNERELLO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "985-320-5175"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "PHY.006667-IR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2139160",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2201930",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greensburg Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Greensburg Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ladonna N Evans, NP
• Kristie Faust, PNP
• Fred'S Inc
• Audrey Clark Gordon, SPEECH THERAPIST
• Greensburg Family Pharmacy
• Daranecia Griffin
• Jennifer Guillory, RPH
• H10 Pediatrics & Family Clinic LLC
• Dale Valerie Haase, LCSW
• Dreveion Oneal Hitchen

• All providers in Greensburg, LA
• Community/Retail Pharmacy in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.