Organization Active NPI

Mouton Pharmacy Inc

  • Community/Retail Pharmacy
  • Rayne, LA
National Provider Identifier
1366439648
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
OS01568 Issued in AR
Legal business name
MOUTON PHARMACY INC
Doing business as
Mouton Pharmacy Inc
Practice address
301 S Adams Ave
Rayne, LA 70578-5837
Phone
(337) 334-2117
Fax
(337) 334-7668
NPI assigned
Oct 3, 2005
Last updated
Aug 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Authorized official

Name
Andrew Mouton
Title
Manager/Owner
Phone
(337) 334-2117

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X PHY.002569-IR LA
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X OS01568 AR Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

301 S Adams Ave
Rayne, LA 70578-5837

Mailing address

PO Box 93
Rayne, LA 70578-0093

Other names 1

  • MOUTON PHARMACY INC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930002596 LA DME Supplier - Pharmacy 5193845238 Practice locations: Rayne, LA
O20110203000587 LA Part B Supplier - Mass Immunization (Roster Biller Only) 5193845238 Practice locations: Rayne, LA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Mouton Pharmacy Inc.301 S Adams Ave, Rayne, LA 70578-5837(337) 334-2117 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Hospital Beds (Electric)|Hospital Beds (Manual)|Canes and/or Crutches|Patient Lifts|Seat Lift Mechanisms|Walkers|Wheelchairs (Standard Manu… Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

Locations

301 S Adams Ave
Rayne, LA 70578
Phone (337) 334-2117

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756252800000",
    "number": "1366439648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 93",
            "city": "RAYNE",
            "state": "LA",
            "postal_code": "705780093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S ADAMS AVE",
            "city": "RAYNE",
            "state": "LA",
            "postal_code": "705785837",
            "telephone_number": "337-334-2117",
            "fax_number": "337-334-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUTON PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-03",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A",
        "authorized_official_last_name": "MOUTON",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "337-334-2117"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "LA",
            "license": "PHY.002569-IR",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "OS01568",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOUTON PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rayne, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.