Active NPI
Funmilayo Yesufu
- Pharmacist
- Ponchatoula, LA
National Provider Identifier
1427820836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 025037
- Practice address
- 1100 W Pine St
Ponchatoula, LA 70454-3700 - Phone
- (985) 386-2421
- NPI assigned
- Oct 27, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 025037 | LA | Primary |
Addresses
Primary practice location
1100 W Pine St
Ponchatoula, LA 70454-3700
Mailing address
109 New Camellia Blvd Ste 106
Covington, LA 70433-7829
Phone (985) 792-3521
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025037 | LA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
1100 W Pine St
Ponchatoula, LA 70454
Phone (985) 386-2421
Organizations & group practices 2
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.
-
- Pharmacy
- Ponchatoula, LA
- NPI 1083701213
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698364800000",
"number": "1427820836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 NEW CAMELLIA BLVD STE 106",
"city": "COVINGTON",
"state": "LA",
"postal_code": "704337829",
"telephone_number": "985-792-3521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 W PINE ST",
"city": "PONCHATOULA",
"state": "LA",
"postal_code": "704543700",
"telephone_number": "985-386-2421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YESUFU",
"first_name": "FUNMILAYO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-27",
"last_updated": "2023-10-27",
"certification_date": "2023-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "025037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponchatoula, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.