NDD LLC

Organization Active NPI Community/Retail Pharmacy · Stonewall, LA

NPI 1255732012 · NPPES record last updated Sep 30, 2022

Key facts

NPI
1255732012
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
PHY.006948-IR (LA)
Legal business name
NDD LLC
Practice address
316 Plantation Hills Blvd Ste a
Stonewall, LA 71078-2838
Phone
(318) 775-4371
Fax
(318) 775-4369
NPI assigned
Sep 11, 2014
Organization subpart
No

Authorized official

Name
Amanda Dominguez
Title
Owner
Phone
(318) 775-4371

Practitioners 2

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

National Provider Directory

Locations

316 Plantation Hills Blvd
#A
Stonewall, LA 71078
Phone (318) 775-4371

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY.006948-IR LA Yes
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

316 Plantation Hills Blvd Ste a
Stonewall, LA 71078-2838

Mailing address

316 Plantation Hills Blvd Ste a
Stonewall, LA 71078-2838
Phone (318) 775-4371

Other identifiers

IdentifierTypeStateIssuer
2147912OtherPK
2203061MedicaidLA

Other names

  • North Desoto Drug Doing business as

Other providers in Stonewall, LA

All providers in Stonewall, LA · Community/Retail Pharmacy in Louisiana

Sources for this page

Verify at the official NPI Registry.