Individual provider Active NPI

Ivan Landry, PHARMD

  • Pharmacist
  • Broussard, LA
National Provider Identifier
1376954750
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PST.014938 Issued in LA
Practice address
103 E Main St
Broussard, LA 70518-4616
Phone
(337) 839-8880
Fax
(337) 839-8881
NPI assigned
May 19, 2014
Last updated
May 1, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PST.014938 LA Primary

Addresses

Primary practice location

103 E Main St
Broussard, LA 70518-4616

Mailing address

103 E Main St
Broussard, LA 70518-4616
Phone (337) 839-8880

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PST.014938LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ijl Investments LLC Current Accepting new patients
Maddi Girl LLC Current Accepting new patients
Rx4Fun Investments, LLC Current Accepting new patients
Towne Pharmacy LLC PastSince Jul 24, 2022 Accepting new patients
Towne Pharmacy LLC PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1376954750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 E MAIN ST",
            "city": "BROUSSARD",
            "state": "LA",
            "postal_code": "705184616",
            "telephone_number": "337-839-8880",
            "fax_number": "337-839-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 E MAIN ST",
            "city": "BROUSSARD",
            "state": "LA",
            "postal_code": "705184616",
            "telephone_number": "337-839-8880",
            "fax_number": "337-839-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "IVAN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-19",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "PST.014938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broussard, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; 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.