Active NPI
Marcillin Zetrenne
- Pharmacist
- Leesville, LA
National Provider Identifier
1225893308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PST.025173
- Practice address
- 2204 S 5TH St
Leesville, LA 71446-5327 - Phone
- (337) 238-9305
- NPI assigned
- Feb 16, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PST.025173 | LA | Primary |
Addresses
Primary practice location
2204 S 5TH St
Leesville, LA 71446-5327
Mailing address
1450 NW 47TH Ave
Coconut Creek, FL 33063-3947
Phone (954) 903-8196
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PST.025173 | LA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1708041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708041600000",
"number": "1225893308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1450 NW 47TH AVE",
"city": "COCONUT CREEK",
"state": "FL",
"postal_code": "330633947",
"telephone_number": "954-903-8196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2204 S 5TH ST",
"city": "LEESVILLE",
"state": "LA",
"postal_code": "714465327",
"telephone_number": "337-238-9305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZETRENNE",
"first_name": "MARCILLIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-02-16",
"last_updated": "2024-02-16",
"certification_date": "2024-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "PST.025173",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leesville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.