Phoenix Rexall Drugs Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

891IR Issued in LA

Legal business name

PHOENIX REXALL DRUGS INC

Doing business as

Phoenix Pharmacy

Practice address

101 N 3Rd St
Leesville, LA 71446-4013

Phone

(337) 239-3421

Fax

(337) 392-6212

NPI assigned

Aug 30, 2006

Last updated

Sep 2, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cynthia Wann, CPT

Title

Manager

Phone

(337) 239-3421

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• PHOENIX PHARMACY Doing business as

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314921600000",
    "number": "1609986116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 172",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714960172",
            "telephone_number": "337-239-3421",
            "fax_number": "337-239-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N 3RD ST",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464013",
            "telephone_number": "337-239-3421",
            "fax_number": "337-392-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX REXALL DRUGS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2011-09-02",
        "status": "A",
        "authorized_official_last_name": "WANN",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "337-239-3421",
        "authorized_official_credential": "CPT"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "891IR",
            "primary": true
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1907027",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1233854",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHOENIX PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Leesville, LA
• Providers in Leesville, 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 2, 2011; 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.