NPIMap

Organization Active NPI

Dave's Village Drugs, Inc.

  • Pharmacist
  • Houma, LA
National Provider Identifier
1619019551
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2191R Issued in LA
Legal business name
DAVE'S VILLAGE DRUGS, INC.
Practice address
1620 Prospect Blvd
Houma, LA 70363-3785
Phone
(985) 868-4910
Fax
(985) 851-7815
NPI assigned
Feb 13, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
David Louis Matherne
Title
President
Phone
(985) 868-4910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 2191R LA Primary

Addresses

Primary practice location

1620 Prospect Blvd
Houma, LA 70363-3785

Mailing address

1620 Prospect Blvd
Houma, LA 70363-3785

Other identifiers 1

IdentifierTypeStateIssuer
1212024MedicaidLA

National Provider Directory

National Provider Directory

Locations

1620 Prospect Blvd
Houma, LA 70363
Phone (985) 868-4910

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619019551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 PROSPECT BLVD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703633785",
            "fax_number": "985-851-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 PROSPECT BLVD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703633785",
            "telephone_number": "985-868-4910",
            "fax_number": "985-851-7815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVE'S VILLAGE DRUGS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATHERNE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "985-868-4910"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "2191R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1212024",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houma, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.