Jonathan C Gordon, PHARMD
Individual provider Active NPI Pharmacist · Maurepas, LA
NPI 1477124147 · NPPES record last updated Jul 5, 2021
Key facts
- NPI
- 1477124147
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 023907 (LA)
- Practice address
- 18525 Highway 22
Maurepas, LA 70449-3015 - Phone
- (225) 267-4340
- NPI assigned
- Jul 5, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 023907 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chris Pharmacy and Gifts LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 023907 | LA | Yes |
Addresses
Primary practice location
18525 Highway 22
Maurepas, LA 70449-3015
Mailing address
22840 Alex Willie Rd
Livingston, LA 70754-5250
Phone (225) 290-1536
Other providers in Maurepas, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 5, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.