Willow Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY.006595-IR Issued in LA

Legal business name

WILLOW PHARMACY INC

Practice address

1519 Highway 22 W
Madisonville Center Suite 5
Madisonville, LA 70447-9489

Phone

(985) 792-2391

Fax

(855) 848-3661

NPI assigned

Sep 14, 2012

Organization subpart

No

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

Authorized official

Name

Darren Martin

Title

Pic

Phone

(877) 558-7943

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Willow Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471996800000",
    "number": "1649520859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1519 HIGHWAY 22 W",
            "address_2": "MADISONVILLE CENTER SUITE 5",
            "city": "MADISONVILLE",
            "state": "LA",
            "postal_code": "704479489",
            "telephone_number": "985-792-2391",
            "fax_number": "855-848-3661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 HIGHWAY 22 W",
            "address_2": "MADISONVILLE CENTER SUITE 5",
            "city": "MADISONVILLE",
            "state": "LA",
            "postal_code": "704479489",
            "telephone_number": "985-792-2391",
            "fax_number": "855-848-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-14",
        "last_updated": "2016-08-24",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "DARREN",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "877-558-7943"
    },
    "taxonomies": [
        {
            "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.006595-IR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2137008",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willow Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vesta Batchelder LDN Rd Inc
• Brooke Virginia Vinturella, DDS
• Rebecca Walker, CCC-SLP
• Logan Walther, MS, CCC-SLP
• Aaron Williams, PHARMD
• Ryan Michael Woods
• Taylor Schaal Wynn

• Community/Retail Pharmacy in Madisonville, LA
• Providers in Madisonville, 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 Aug 24, 2016; 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.