Organization Active NPI

Vaughans City Drugs of Concordia Inc.

  • Community/Retail Pharmacy
  • Ferriday, LA
National Provider Identifier
1366504169
Registry record updated Nov 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5305IR Issued in LA
Legal business name
VAUGHANS CITY DRUGS OF CONCORDIA INC.
Practice address
109 Ee Wallace Blvd N
Ferriday, LA 71334-2819
Phone
(318) 757-4811
Fax
(318) 757-4439
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2024

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

Authorized official

Name
Christopher L Vaughan, RPHNPI 1760770044
Title
Owner
Phone
(318) 757-4811

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X 5305IR LA Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

109 Ee Wallace Blvd N
Ferriday, LA 71334-2819

Mailing address

109 Ee Wallace Blvd
Ferriday, LA 71334-2806
Phone (318) 757-4811

Other identifiers 1

IdentifierTypeStateIssuer
1271993MedicaidLA

Other names 1

  • Vaughans City Drugs Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090915000679 LA Part B Supplier - Mass Immunization (Roster Biller Only) 8426104589 Practice locations: Ferriday, LA
O20110524000321 LA DME Supplier - Pharmacy 8426104589 Practice locations: Ferriday, 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
Vaughan'S City Drug109 Ee Wallace Blvd N, Ferriday, LA 71334-2819(318) 757-4811 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Orthoses: Off-The-Shelf Accepts assignmentParticipating since Jun 16, 2009

National Provider Directory

National Provider Directory

Locations

109 EE Wallace Blvd N
Ferriday, LA 71334
Phone (318) 757-4811

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732406400000",
    "number": "1366504169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 EE WALLACE BLVD",
            "city": "FERRIDAY",
            "state": "LA",
            "postal_code": "713342806",
            "telephone_number": "318-757-4811",
            "fax_number": "318-757-4439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 EE WALLACE BLVD N",
            "city": "FERRIDAY",
            "state": "LA",
            "postal_code": "713342819",
            "telephone_number": "318-757-4811",
            "fax_number": "318-757-4439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAUGHANS CITY DRUGS OF CONCORDIA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2024-11-24",
        "certification_date": "2024-11-24",
        "status": "A",
        "authorized_official_last_name": "VAUGHAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-757-4811",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "5305IR",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1271993",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vaughans City Drugs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ferriday, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2024; 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.