Lourdes, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY.001872-IR Issued in LA

Legal business name

LOURDES, LLC

Practice address

220 Highland Dr
Ste E
Many, LA 71449-3764

Phone

(318) 256-3426

Fax

(318) 256-0101

NPI assigned

Jun 4, 2018

Organization subpart

No

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

Authorized official

Name

Edmond Ducote

Title

Owner

Phone

(318) 256-3426

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540252800000",
    "number": "1396237475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 HIGHLAND DR",
            "address_2": "STE E",
            "city": "MANY",
            "state": "LA",
            "postal_code": "714493764",
            "telephone_number": "318-256-3426",
            "fax_number": "318-256-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 HIGHLAND DR",
            "address_2": "STE E",
            "city": "MANY",
            "state": "LA",
            "postal_code": "714493764",
            "telephone_number": "318-256-3426",
            "fax_number": "318-256-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOURDES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-04",
        "last_updated": "2018-10-23",
        "status": "A",
        "authorized_official_last_name": "DUCOTE",
        "authorized_official_first_name": "EDMOND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-256-3426"
    },
    "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": "PHY.001872-IR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255190",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2177268",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Many, LA
• Providers in Many, 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 Oct 23, 2018; 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.