North Caddo Drug

Primary specialty

PharmacistTaxonomy code 183500000X

License

4558IR Issued in LA

Legal business name

NORTH CADDO DRUG

Practice address

144 W Louisiana Avenue
Vivian, LA 71082-2836

Phone

(318) 375-2573

Fax

(317) 375-3156

NPI assigned

Oct 31, 2006

Last updated

Aug 22, 2020By 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

Jack Kaleel

Title

Owner

Phone

(318) 375-2573

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285710236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 W LOUISIANA AVE",
            "city": "VIVIAN",
            "state": "LA",
            "postal_code": "710822836",
            "telephone_number": "318-375-2573",
            "fax_number": "317-375-3156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 W LOUISIANA AVENUE",
            "city": "VIVIAN",
            "state": "LA",
            "postal_code": "710822836",
            "telephone_number": "318-375-2573",
            "fax_number": "317-375-3156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CADDO DRUG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KALEEL",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-375-2573"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "4558IR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medical & Surgical Clinic a Medical
• Lauretta Montgomery
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• Christian Nguyen
• North Caddo Anesthesia Billing
• North Caddo Hospital Service District (NCMC Medical and Surgical Clinic)
• North Caddo Hospital Service District (NCMC Medical & Surgical Clinic)
• North Caddo Hospital Service District (North Caddo Medical Center)
• North Caddo Hospital Service District (North Caddo Medical Center)
• North Caddo Hospital Service District

• Pharmacist in Vivian, LA
• Providers in Vivian, LA by specialty
• Pharmacist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.