NPIMap

Organization Active NPI

Mandeville Pharmacy LLC

  • Community/Retail Pharmacy
  • Mandeville, LA
National Provider Identifier
1548616998
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY.007316-IR Issued in LA
Legal business name
MANDEVILLE PHARMACY LLC
Practice address
1655 Highway 190
Mandeville, LA 70448-3582
Phone
(985) 778-2306
Fax
(985) 778-2404
NPI assigned
May 4, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Authorized official

Name
Malcolm ArmstrongNPI 1558760553
Title
President/Pharmacy MGR.
Phone
(985) 778-2306

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
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY.007316-IR LA Primary

Addresses

Primary practice location

1655 Highway 190
Mandeville, LA 70448-3582

Mailing address

1655 Highway 190
Mandeville, LA 70448-3582
Phone (985) 778-2306

Other identifiers 2

IdentifierTypeStateIssuer
2204491MedicaidLA
2159916OtherPK

Other names 1

  • Mandeville Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

1655 Highway 190
Mandeville, LA 70448
Phone (985) 778-2306

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": "1462320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752105600000",
    "number": "1548616998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 HIGHWAY 190",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704483582",
            "telephone_number": "985-778-2306",
            "fax_number": "985-778-2404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 HIGHWAY 190",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704483582",
            "telephone_number": "985-778-2306",
            "fax_number": "985-778-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANDEVILLE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-04",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A",
        "authorized_official_last_name": "ARMSTRONG",
        "authorized_official_first_name": "MALCOLM",
        "authorized_official_title_or_position": "PRESIDENT/PHARMACY MGR.",
        "authorized_official_telephone_number": "985-778-2306"
    },
    "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.007316-IR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2204491",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2159916",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mandeville Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.