Wagih Sous

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

015726 Issued in LA

Practice address

4283 Carter St.
Vidalia, LA 71373

Phone

(318) 336-8801

NPI assigned

Dec 3, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Wal-Mart Stores East LP

  dba Walmart Pharmacy 10-1106

  • Community/Retail Pharmacy
  • Vidalia, LA
  • NPI 1083632566
  NPD (past)
• Wal-Mart Stores East, LP

  dba Walmart Pharmacy 10-2229

  • Pharmacy
  • Apollo Beach, FL
  • NPI 1437027208
  NPD (past)

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

{
    "created_epoch": "1449100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449100800000",
    "number": "1609241587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4283 CARTER ST",
            "city": "VIDALIA",
            "state": "LA",
            "postal_code": "713733148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4283 CARTER ST.",
            "city": "VIDALIA",
            "state": "LA",
            "postal_code": "71373",
            "telephone_number": "318-336-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUS",
        "first_name": "WAGIH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-03",
        "last_updated": "2015-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "LA",
            "license": "015726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenya Simmons
• Kimberly Simpson
• Angela Smith
• Charlene Deonne Smith, MS,CCC-A
• Terry Glynn Smith
• Danielle Spencer, MHP
• Veronica Stacker
• Ta'Larra Stampley
• Twyane Gail Stewart
• Shakeria Stumps

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Vidalia, LA
• Providers in Vidalia, LA by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Louisiana

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

Verify at the official NPI Registry.