Ted S Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY.005750-IR Issued in LA

Legal business name

TED S PHARMACY LLC

Doing business as

Ted's Pharmacy

Practice address

1866 Main St
Haynesville, LA 71038-4904

Phone

(318) 624-1053

Fax

(318) 624-2233

NPI assigned

Mar 28, 2007

Organization subpart

No

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

Authorized official

Name

Dan WareNPI 1801388921

Title

Pic

Phone

(318) 624-1053

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Ted's Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Practitioners 1

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

• Dan Thomas Ware, RPH

  • Pharmacist
  • Haynesville, LA
  • NPI 1801388921
  NPD Authorized official

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1538288113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1866 MAIN ST",
            "city": "HAYNESVILLE",
            "state": "LA",
            "postal_code": "710384904",
            "telephone_number": "318-624-1053",
            "fax_number": "318-624-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1866 MAIN ST",
            "city": "HAYNESVILLE",
            "state": "LA",
            "postal_code": "710384904",
            "telephone_number": "318-624-1053",
            "fax_number": "318-624-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TED S PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A",
        "authorized_official_last_name": "WARE",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "318-624-1053"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "PHY.005750-IR",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2029769",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1269719",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ted's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sandra Killgore Meisler, PH
• Moseley E Mellinger, LPC, NCC
• Samantha Modisette
• Eddy Waller Sherman II, DDS
• Springhill Medical Services, Inc. (Butler-Abshire Medical Clinic)
• Ted's Pharmacy
• Tri-State Health Services of Cenla, LLC (Heritage Nursing Center)
• Dan Thomas Ware, RPH
• Bethany Willis, IBCLC
• WK Butler-Abshire Medical Clinic

• Community/Retail Pharmacy in Haynesville, LA
• Providers in Haynesville, LA by specialty
• Community/Retail Pharmacy in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.