Active NPI
Village Pharmacy of Mer Rouge Inc
Doing business as Village Pharmacy Inc
- Community/Retail Pharmacy
- Mer Rouge, LA
National Provider Identifier
1619070786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHY.001475-IR
- Legal business name
- VILLAGE PHARMACY OF MER ROUGE INC
- Doing business as
- Village Pharmacy Inc
- Practice address
- 308 Davenport
Mer Rouge, LA 71261-0165 - Phone
- (318) 647-5786
- Fax
- (318) 647-3539
- NPI assigned
- Sep 6, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Elizabeth Blackwell
- Title
- Ceo
- Phone
- (318) 647-5786
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHY.001475-IR | LA | Primary |
Addresses
Primary practice location
308 Davenport
Mer Rouge, LA 71261-0165
Mailing address
PO Box 165
Mer Rouge, LA 71261-0165
Phone (318) 647-5786
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1918575 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| 1251313 | Medicaid | LA |
Other names 1
- VILLAGE PHARMACY INC
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1294358400000",
"number": "1619070786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 165",
"city": "MER ROUGE",
"state": "LA",
"postal_code": "712610165",
"telephone_number": "318-647-5786",
"fax_number": "318-647-3539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 DAVENPORT",
"city": "MER ROUGE",
"state": "LA",
"postal_code": "712610165",
"telephone_number": "318-647-5786",
"fax_number": "318-647-3539"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VILLAGE PHARMACY OF MER ROUGE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-06",
"last_updated": "2011-01-07",
"status": "A",
"authorized_official_last_name": "BLACKWELL",
"authorized_official_first_name": "ELIZABETH",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "318-647-5786"
},
"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": "PHY.001475-IR",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
"identifier": "1918575",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1251313",
"state": "LA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "VILLAGE PHARMACY INC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Mer Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.