Active NPI
Glenn Joseph Faul
- Pharmacist
- Lafayette, LA
National Provider Identifier
1639466345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11870
- Practice address
- 4313 Ambassador Caffery Pkwy
Lafayette, LA 70508-6703 - Phone
- (337) 981-9673
- NPI assigned
- Jul 1, 2011
- Last updated
- Jul 1, 2011
- Sex
- Male
- Sole proprietor
- No
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 | 11870 | LA | Primary |
Addresses
Primary practice location
4313 Ambassador Caffery Pkwy
Lafayette, LA 70508-6703
Mailing address
4313 Ambassador Caffery Pkwy
Lafayette, LA 70508-6703
Phone (337) 981-9673
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1269735 | Medicaid | LA |
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 |
|---|---|---|---|
| 11870 | LA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309478400000",
"number": "1639466345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4313 AMBASSADOR CAFFERY PKWY",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705086703",
"telephone_number": "337-981-9673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4313 AMBASSADOR CAFFERY PKWY",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705086703",
"telephone_number": "337-981-9673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAUL",
"first_name": "GLENN",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-01",
"last_updated": "2011-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "11870",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1269735",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.