Bridget Anne Octave
Individual provider Active NPI Pharmacist · Geismar, LA
NPI 1295041929 · NPPES record last updated Aug 18, 2010
Key facts
- NPI
- 1295041929
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 13839 (LA)
- Practice address
- 12506 Highway 73
Geismar, LA 70734-3209 - Phone
- (225) 677-7607
- NPI assigned
- Aug 18, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13839 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co. | Past |
Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13839 | LA | Yes |
Addresses
Primary practice location
12506 Highway 73
Geismar, LA 70734-3209
Mailing address
PO Box 69
Donaldsonville, LA 70346-0069
Phone (225) 473-3537
Other providers in Geismar, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.