Mouton Pharmacy Inc

Organization Active NPI Community/Retail Pharmacy · Rayne, LA

NPI 1366439648 · NPPES record last updated Aug 27, 2025

Key facts

NPI
1366439648
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
OS01568 (AR)
Legal business name
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
Organization subpart
No

Authorized official

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

Practitioners 3

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here 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 assignment
Participating since Jan 1, 1998

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in LA

Medicare enrollment records

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

National Provider Directory

Locations

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

Specialties & licenses

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

IdentifierTypeStateIssuer
2211382MedicaidLA
2032645OtherPK

Other names

  • MOUTON PHARMACY INC Doing business as

Other providers in Rayne, LA

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

Sources for this page

Verify at the official NPI Registry.