Organization Active NPI

Parkway Pharmacy South LLC

  • Community/Retail Pharmacy
  • Monroe, LA
National Provider Identifier
1508522459
Registry record updated Oct 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PARKWAY PHARMACY SOUTH LLC
Practice address
1666 Richwood Road 1 Ste 2
Monroe, LA 71202-6892
Phone
(318) 734-0046
Fax
(318) 734-0014
NPI assigned
Nov 15, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2025

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

Authorized official

Name
Lateef Odeyemi
Title
Owner
Phone
(318) 243-4748

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1666 Richwood Road 1 Ste 2
Monroe, LA 71202-6892

Mailing address

1666 Richwood Road 1 Ste 2
Monroe, LA 71202-6892
Phone (318) 734-0046

Other identifiers 1

IdentifierTypeStateIssuer
2208829MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220210002571 LA Part B Supplier - Pharmacy 1355734534 Practice locations: Monroe, LA

National Provider Directory

National Provider Directory

Locations

1666 Richwood Road 1
Ste 2
Monroe, LA 71202
Phone (318) 734-0046

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": "1636934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760745600000",
    "number": "1508522459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1666 RICHWOOD ROAD 1 STE 2",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712026892",
            "telephone_number": "318-734-0046",
            "fax_number": "318-734-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1666 RICHWOOD ROAD 1 STE 2",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712026892",
            "telephone_number": "318-734-0046",
            "fax_number": "318-734-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKWAY PHARMACY SOUTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-15",
        "last_updated": "2025-10-18",
        "certification_date": "2025-10-18",
        "status": "A",
        "authorized_official_last_name": "ODEYEMI",
        "authorized_official_first_name": "LATEEF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-243-4748"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2208829",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2025; 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.

Verify at the official NPI Registry.