Active NPI
Ebony Cook
- Pharmacist
- Lake Charles, LA
National Provider Identifier
1609159029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 019117
- Practice address
- 4060 Ryan St
Lake Charles, LA 70605-2841 - Phone
- (337) 478-9197
- NPI assigned
- Sep 21, 2011
- Last updated
- Sep 3, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | 019117 | LA | Primary |
Addresses
Primary practice location
4060 Ryan St
Lake Charles, LA 70605-2841
Mailing address
2863 Ambassador Caffery Pkwy
Lafayette, LA 70506-5905
Phone (337) 406-8806
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019117 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Albertsons LLC | Past | Accepting new patients | |
| Albertsons 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.
-
dba Albertsons Pharmacy #0717
- Community/Retail Pharmacy
- Lake Charles, LA
- NPI 1598702011
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441238400000",
"number": "1609159029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2863 AMBASSADOR CAFFERY PKWY",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705065905",
"telephone_number": "337-406-8806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4060 RYAN ST",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706052841",
"telephone_number": "337-478-9197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "EBONY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-21",
"last_updated": "2015-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "019117",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Charles, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.