Organization Active NPI

Wellnecessities Pharmacy Lab

  • Pharmacist
  • Shreveport, LA
National Provider Identifier
1649256058
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
10973 Issued in LA
Legal business name
WELLNECESSITIES PHARMACY LAB
Practice address
8835 Line Ave
Shreveport, LA 71106-6718
Phone
(318) 222-0885
Fax
(318) 861-7431
NPI assigned
Dec 16, 2005
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
Chris Y Kalstone, MS,RPH
Title
Compounding Pharmacist
Phone
(318) 222-0885

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193200000X MULTI-SPECIALTY GROUP 183500000X 10973 LA Primary

Addresses

Primary practice location

8835 Line Ave
Shreveport, LA 71106-6718

Mailing address

8835 Line Ave
Shreveport, LA 71106-6718
Phone (318) 222-0885

Other identifiers 1

IdentifierTypeStateIssuer
1271969MedicaidLA

National Provider Directory

National Provider Directory

Locations

8835 Line Ave
Shreveport, LA 71106
Phone (318) 222-0885

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649256058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8835 LINE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711066718",
            "telephone_number": "318-222-0885",
            "fax_number": "318-861-7431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8835 LINE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711066718",
            "telephone_number": "318-222-0885",
            "fax_number": "318-861-7431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNECESSITIES PHARMACY LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KALSTONE",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "COMPOUNDING PHARMACIST",
        "authorized_official_telephone_number": "318-222-0885",
        "authorized_official_credential": "MS,RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "10973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1271969",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, 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.