Active NPI
Erhard Vitel Dzouankeu Kamdoum, PHARMD
- Pharmacist
- Youngsville, LA
National Provider Identifier
1487240735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PST.023413
- Practice address
- 2910 E Milton Ave
Youngsville, LA 70592-6766 - Phone
- (337) 856-8881
- NPI assigned
- Dec 20, 2020
- Last updated
- Dec 20, 2020
- Sex
- Male
- 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 | PST.023413 | LA | Primary |
Addresses
Primary practice location
2910 E Milton Ave
Youngsville, LA 70592-6766
Mailing address
2910 E Milton Ave
Youngsville, LA 70592-6766
Phone (337) 856-8881
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | cvshealth.com | CVS Health Corp |
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PST.023413 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Louisiana CVS Pharmacy, L.L.C. | Past | Accepting new patients | |
| Louisiana CVS Pharmacy LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608422400000",
"number": "1487240735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2910 E MILTON AVE",
"city": "YOUNGSVILLE",
"state": "LA",
"postal_code": "705926766",
"telephone_number": "337-856-8881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2910 E MILTON AVE",
"city": "YOUNGSVILLE",
"state": "LA",
"postal_code": "705926766",
"telephone_number": "337-856-8881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DZOUANKEU KAMDOUM",
"first_name": "ERHARD VITEL",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-20",
"last_updated": "2020-12-20",
"certification_date": "2020-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "PST.023413",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "cvshealth.com",
"affiliation": "Y",
"affiliationName": "CVS Health Corp",
"address_1": "2910 E Milton Ave",
"city": "Youngsville",
"state": "LA",
"country_code": "US",
"postal_code": "705926766",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Youngsville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.