Island Drug and Wellness, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

ISLAND DRUG AND WELLNESS, LLC

Practice address

311 Chisum St
Sicily Island, LA 71368-4807

Phone

(318) 389-5807

Fax

(318) 389-1090

NPI assigned

Dec 7, 2020

Organization subpart

No

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

Authorized official

Name

John Bannister

Title

Manager

Phone

(318) 927-3523

Specialties & licenses 2

Addresses

Other identifiers 2

Tax ID family

Deep South Medical Supply LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Deep South Medical Supply, LLC

  • Community/Retail Pharmacy
  • Sicily Island, LA
  • NPI 1801356621
  NPD tax ID

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1548866429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 729",
            "city": "BENTON",
            "state": "LA",
            "postal_code": "710060729",
            "telephone_number": "318-389-5807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 CHISUM ST",
            "city": "SICILY ISLAND",
            "state": "LA",
            "postal_code": "713684807",
            "telephone_number": "318-389-5807",
            "fax_number": "318-389-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND DRUG AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-07",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A",
        "authorized_official_last_name": "BANNISTER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "318-927-3523"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "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": "PHARMACY PERMIT",
            "identifier": "PHY.008184-IR",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2207385",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob Victor Crawford, FNP
• D.C. Lamarr Contracting LLC
• Deep South Medical Supply, LLC
• Summer Leigh Greer, NP-C
• Frances Hester, DR
• Island Institutional Pharmacy
• Island Pharmacy
• John Bird (Island Medical Supply)
• John Bird (Island Pharmacy)
• Hershel Dale Meade, MD

• Community/Retail Pharmacy in Sicily Island, LA
• Providers in Sicily Island, 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 Mar 23, 2021; 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.