Medicis LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

MEDICIS LLC

Practice address

1727 Imperial Blvd BLDG 4
Lake Charles, LA 70605-5393

Phone

(337) 540-1868

NPI assigned

Jun 11, 2019

Last updated

Jun 11, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James Thibodeaux

Title

Pharmacy Manager

Phone

(337) 540-1868

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1265091474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 IMPERIAL BLVD BLDG 4",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055393",
            "telephone_number": "337-540-1868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 IMPERIAL BLVD BLDG 4",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055393",
            "telephone_number": "337-540-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-11",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "THIBODEAUX",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "337-540-1868"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacy in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Pharmacy in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.