NPIMap

Organization Active NPI

CCC Pharmacy LLC

  • Durable Medical Equipment & Medical Supplies
  • Alexandria, LA
National Provider Identifier
1467755264
Registry record updated Jan 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
PHY006277-IR Issued in LA
Legal business name
CCC PHARMACY LLC
Practice address
180 Windermere Blvd
Alexandria, LA 71303-3535
Phone
(318) 445-8770
Fax
(318) 445-8979
NPI assigned
Dec 16, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2016

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

Authorized official

Name
Mr. Kevin Paul RobichauxNPI 1356924864
Title
Manager
Phone
(318) 445-8770

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X PHY006277-IR LA Primary
Long Term Care Pharmacy 3336L0003X PHY-0622IR LA

Addresses

Primary practice location

180 Windermere Blvd
Alexandria, LA 71303-3535

Mailing address

180 Windermere Blvd
Alexandria, LA 71303-3535
Phone (318) 445-8770

Other identifiers 1

IdentifierTypeStateIssuer
2200216MedicaidLA

Other names 1

  • FUSIONCARE PHARMACY Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1292457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453248000000",
    "number": "1467755264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 WINDERMERE BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033535",
            "telephone_number": "318-445-8770",
            "fax_number": "318-445-8979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 WINDERMERE BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033535",
            "telephone_number": "318-445-8770",
            "fax_number": "318-445-8979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCC PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-16",
        "last_updated": "2016-01-20",
        "status": "A",
        "authorized_official_last_name": "ROBICHAUX",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "318-445-8770",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "LA",
            "license": "PHY006277-IR",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "LA",
            "license": "PHY-0622IR",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2200216",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FUSIONCARE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2016; 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.