NPIMap

Organization Active NPI

Medcore Specialty Pharmacy

  • Specialty Pharmacy
  • Coushatta, LA
National Provider Identifier
1255566857
Registry record updated May 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
License
6118 Issued in LA
Legal business name
MEDCORE SPECIALTY PHARMACY
Practice address
1435 E. Carroll St.
Suite B
Coushatta, LA 71019
Phone
(318) 932-8661
NPI assigned
May 27, 2009
Last updated
May 27, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2009

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

Authorized official

Name
Ray Mabile, RPH
Title
Owner/Pharmacist
Phone
(318) 932-3083

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialty Pharmacy 3336S0011X 6118 LA Primary

Addresses

Primary practice location

1435 E. Carroll St.
Suite B
Coushatta, LA 71019

Mailing address

1435 E. Carroll St.
Suite B
Coushatta, LA 71019
Phone (318) 932-8661

Other identifiers 1

IdentifierTypeStateIssuer
6118OtherLALA BOARD OF PHARMACY PERMIT

National Provider Directory

National Provider Directory

Locations

1435 E Carrol St
Ste B
Coushatta, LA 71019
Phone (318) 932-8661

NPI Registry JSON

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

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243382400000",
    "number": "1255566857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 E. CARROLL ST.",
            "address_2": "SUITE B",
            "city": "COUSHATTA",
            "state": "LA",
            "postal_code": "71019",
            "telephone_number": "318-932-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 E. CARROLL ST.",
            "address_2": "SUITE B",
            "city": "COUSHATTA",
            "state": "LA",
            "postal_code": "71019",
            "telephone_number": "318-932-8661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDCORE SPECIALTY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-27",
        "last_updated": "2009-05-27",
        "status": "A",
        "authorized_official_last_name": "MABILE",
        "authorized_official_first_name": "RAY",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "318-932-3083",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "LA",
            "license": "6118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA BOARD OF PHARMACY PERMIT",
            "identifier": "6118",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coushatta, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; 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.