Active NPI
North Caddo Medical Center Community RX
- Community/Retail Pharmacy
- Shreveport, LA
National Provider Identifier
1417719972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- NORTH CADDO MEDICAL CENTER COMMUNITY RX
- Practice address
- 5950 North Market
Shreveport, LA 71107 - Phone
- (318) 375-7200
- NPI assigned
- Jan 29, 2024
- Organization subpart
- Yes
- Parent organization
- NORTH CADDO HOSPITAL SERVICE DISTRICT
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David Jones
- Title
- Ceo
- Phone
- (318) 375-4008
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
5950 North Market
Shreveport, LA 71107
Mailing address
PO Box 792
Vivian, LA 71082-0792
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240604002981 | LA | Part B Supplier - Pharmacy | 1759823834 | Practice locations: Shreveport, LA |
National Provider Directory
National Provider Directory- Part of
- N Caddo Medical Center
Locations
5950 N Market St
Shreveport, LA 71107
Phone (318) 375-7200
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706486400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1728950400000",
"number": "1417719972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 792",
"city": "VIVIAN",
"state": "LA",
"postal_code": "710820792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5950 NORTH MARKET",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "71107",
"telephone_number": "318-375-7200"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTH CADDO MEDICAL CENTER COMMUNITY RX",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "NORTH CADDO HOSPITAL SERVICE DISTRICT",
"enumeration_date": "2024-01-29",
"last_updated": "2024-10-15",
"certification_date": "2024-10-15",
"status": "A",
"authorized_official_last_name": "JONES",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "318-375-4008"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
- Leigh Anne Norman, M.S., CCC-A
- Sandra Cain Normand, LPC
- Normandie SCC LLC (The Guest House Rehabilitation Center)
- Mary Norred
- Amanda Norris
- North Louisiana Internal Medicine
- North Market Chiropractic Clinic
- North West Louisiana Behavioral Services, LLC
- Northeast la Pharmacy (National Pharmacy Services)
- Northern Louisiana Cardiac Services LLC (Advanced Heart and Vascular Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.