Patrick L Boggs

Individual provider Active NPI Pharmacist · Plain Dealing, LA

NPI 1376852145 · NPPES record last updated Sep 28, 2010

Key facts

NPI
1376852145
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
11960 (LA)
Practice address
302 East Palmetto Street
Plain Dealing, LA 71064-0188
Phone
(318) 326-4229
Fax
(318) 326-5903
NPI assigned
Sep 28, 2010
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
11960LAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kelly Pharmacy Inc Kelly Pharmacy & Gifts Current Accepting new patients

Locations

302 E Palmetto Ave
Plain Dealing, LA 71064
Phone (318) 326-4229

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 11960 LA Yes

Addresses

Primary practice location

302 East Palmetto Street
Plain Dealing, LA 71064-0188

Mailing address

PO Box 188
Plain Dealing, LA 71064
Phone (318) 326-4229

Other providers in Plain Dealing, LA

All providers in Plain Dealing, LA · Pharmacist in Louisiana

Sources for this page

Verify at the official NPI Registry.