Broussards Pharmacy of New Iberia Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY005308-IR Issued in LA

Legal business name

BROUSSARDS PHARMACY OF NEW IBERIA INC

Doing business as

Broussards Pharmacy

Practice address

600 W Saint Peter St
New Iberia, LA 70560-3633

Phone

(337) 364-2381

Fax

(337) 364-2386

NPI assigned

Nov 3, 2006

Organization subpart

No

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

Authorized official

Name

Nelson Stelly, RPHRM

Title

Owner

Phone

(337) 364-2381

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• BROUSSARDS PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314748800000",
    "number": "1376622043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W SAINT PETER ST",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705603633",
            "telephone_number": "337-364-2381",
            "fax_number": "337-364-2386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W SAINT PETER ST",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705603633",
            "telephone_number": "337-364-2381",
            "fax_number": "337-364-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROUSSARDS PHARMACY OF NEW IBERIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2011-08-31",
        "status": "A",
        "authorized_official_last_name": "STELLY",
        "authorized_official_first_name": "NELSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-364-2381",
        "authorized_official_credential": "RPHRM"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "PHY005308-IR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1903170",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1271756",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BROUSSARDS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeremy Broussard, D.C.
• Julie Broussard, RPH
• Lena Broussard
• Magan Broussard
• Paul W Broussard, CRNA
• Deja Brown
• Demerit Brown
• Jill G Brown, MD
• Kennell P Brown Jr., D.D.S.
• Lionel Brown

• Community/Retail Pharmacy in New Iberia, LA
• Providers in New Iberia, LA by specialty
• Community/Retail Pharmacy in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; 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.